2023 年 49 巻 10 号 p. 365-373
Ramucirumab (RAM) plus nanoparticle albumin-bound paclitaxel (nab-PTX) combination therapy is conditionally recommended as second-line therapy for advanced or recurrent gastric cancer in Japan. In a Japanese phase II clinical trial, neutropenia induced by RAM + nab-PTX combination therapy was observed in 90.7％ of patients in all grades and 76.7％ in grade 3 and higher, indicating that caution is required. Therefore, identification of risk factors for neutropenia is required to safely continue RAM + nab-PTX combination therapy for advanced or recurrent gastric cancer. Here, we retrospectively investigated the risk factors of severe neutropenia in advanced or recurrent gastric cancer patients who received the combination therapy of RAM + nab-PTX in seven hospitals participating in the Division of Oncology, Aichi Prefectural Society of Hospital Pharmacists.
Of the 40 patients, 22 patients (55％) had severe neutropenia of grade 3 or higher. Investigation of risk factors in these patients revealed that a history of grade 3 or higher neutropenia was a risk factor for developing severe neutropenia of grade 3 or higher (odds ratio 7.35, 95％ confidence interval: 1.130 - 47.7, P < 0.05). In patients with neutropenia of Grade 3 or higher, those who have a history of two or more times of neutropenia tended to have a longer Time-to-Treatment-Failure (P < 0.05). The present findings may be useful in patients with the RAM + nab-PTX combination therapy to reduce severe neutropenia and prolong treatment duration.
