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

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

In a phase I study, 28 patients with treatment-naïve gastric or GEJ adenocarcinoma were administered ramucirumab at 8 mg/kg on days 1 and 8, and pembrolizumab at 200 mg on day 1 of week 3. Patients with both PD-L1—postive or –negative tumors were enrolled. PD-L1 status was assessed by DAKO PD-L1 22C3 IHC pharmDx assay, which established that 68% of the patients enrolled were PD-L1 positive.

Findings showed that 7 patients achieved an objective response, 6 who were positive for PD-L1 and 1 who was not. Additionally, median progression-free survival (PFS) was 5.3 months (95% CI 3.2-1.1). The median PFS observed in this study is comparable with first-line cytotoxic chemotherapy, but the combination regimen of ramucirumab plus pembrolizumab is better tolerated, Chau explains. Median overall survival has not yet been reached.

Chau acknowledges that since the majority of patients were PD-L1 positive, much of the positive response observed with this combination is attributed to that population.