Dr. Chau on the Tolerability of Ramucirumab Plus Pembrolizumab in Gastric/GEJ Cancer

Ian Chau, MD, consultant medical oncologist, Royal Marsden Hospital, discusses the tolerability of ramucirumab (Cyramza) plus pembrolizumab (Keytruda) in gastric or gastroesophageal (GEJ) cancer.

In a phase I study of the combination of ramucirumab plus pembrolizumab in patients with treatment-naïve gastric or GEJ adenocarcinoma, safety and anti-tumor activity were evaluated. Ramucirumab was administered at 8 mg/kg on days 1 and 8, and pembrolizumab at 200 mg on day 1 of week 3. PD-L1 status was assessed by DAKO PD-L1 22C3 IHC pharmDx assay.

Of 28 patients, 7 achieved an objective response, 6 that were positive for PD-L1 and 1 that was not. Additionally, median progression-free survival was 5.3 months (95% CI 3.2-1.1). At the time of data presentation at the 2018 Gastrointestinal Cancers Symposium, median overall survival had not been reached.

This combination is very well tolerated, says Chau, with very few grade 3/4 toxicities, with the most common grade 3 toxicity being hypertension. Compared to standard cytotoxic chemotherapy where there is a high rate of grade 3/4 side effects, this is a well-tolerated combination for the treatment of patients with gastric or GEJ cancer, Chau concludes. This trial is currently ongoing.