2018 Volume 44 Issue 3 Pages 128-135
Ramucirumab (RAM) is a monoclonal antibody of human vascular endothelial growth factor receptor 2 (VEGFR-2). In Japan, it is indicated for combination therapy with paclitaxel (PTX) for advanced/recurrent gastric cancer that cannot be curatively resected. However, the development of severe neutropenia due to RAM administration is considered to be one of the major side effects. Therefore, the principal aims of the present study were to examine whether the risk of neutropenia increases due to RAM + PTX combination therapy compared with PTX monotherapy in Japanese patients with gastric cancer and to elucidate the risk factors of neutropenia due to RAM + PTX combination therapy.
At the Osaka International Cancer Institute, we retrospectively investigated myelosuppression in 26 patients who received RAM + PTX combination therapy and in 25 patients who received PTX monotherapy for advanced/recurrent gastric cancer that cannot be curatively resected. The expression of neutropenia of all grades and of grade 3 or higher were significantly higher in the RAM + PTX group (P < 0.001 and P = 0.045, respectively). Investigation of the risk factors in patients with expression of neutropenia of grade 3 or higher revealed that a low initial lymphocyte count was a risk factor (P = 0.021); that is, the results suggest that neutropenia may be enhanced by administering RAM in combination with PTX. When RAM + PTX combination therapy is administered in patients with a low initial lymphocyte count, it may be necessary to consider measures against infectious diseases and administration of granulocyte-colony stimulating factor (G-CSF) agents, for example.
