177PComparison of nab-paclitaxel plus ramcirumab and paclitaxel plus ramcirumab in patients with pretreated metastatic gastric cancer

Abstract Background Ramcirumab (RAM) plus paclitaxel (PTX) is the standard second-line chemotherapy for metastatic gastric cancer. The ABSOLUTE trial showed that weekly nanoparticle albumin-bound (nab)-PTX was non-inferior to weekly PTX in terms of overall survival (OS). [Objective] This study aimed to evaluate the efficacy and safety of nab-PTX plus RAM compared with PTX plus RAM in metastatic gastric cancer patients, retrospectively. Methods Patients who received RAM plus nab-PTX or PTX in our institution from August 2015 to December 2018 were included in this retrospective study. (PTX plus RAM patients were administered from August 2015 to April 2018, and nab-PTX plus RAM patients received the combination from May 2018 to December 2018). Response rate, progression-free survival (PFS), OS and safety were assessed. Results A total of 79 patients were included in this study (24 in the nab-PTX plus RAM group and 55 in the PTX plus RAM group). Among the 17 patients with measurable lesions in the nab-PTX plus RAM group, 6 achieved PR (an objective response rate of 35%). Among the 38 patients with measurable lesions in the PTX plus RAM group, 8 achieved PR (an objective response rate of 21%). There was no significant difference between the two groups (p = 0.26), but nab-PTX plus RAM tended to produce a higher response rate than PTX plus RAM. The PFS was 5.7 months in the nab-PTX plus RAM group and 5.1 months in the PTX plus RAM group (p = 0.12). OS was not reached in the nab-PTX plus RAM group and was 8.6 months in the PTX plus RAM group (p = 0.27). The improvement rate of ascites did not differ between the two groups (38.4% in the nab-PTX plus RAM group and 40% in the PTX plus RAM group). Neutropenia was the most common grade 3 or 4 hematological toxicity, and there was no difference between the two groups (58.3% in the nab-PTX plus RAM group and 58.2% in the PTX plus RAM group). The incidence of any grade 3 or 4 non-hematological toxicity were also not different between the two groups. Conclusions This study suggests that nab-PTX plus RAM had almost similar efficacy and safety compared with PTX plus RAM in patients with metastatic gastric cancer. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.