Dr. Finn Discusses the Pooled Analysis of REACH and REACH-2 in HCC

Richard S. Finn, MD, assistant professor of medicine, Department of Medicine, Division of Hematology/Oncology, Geffen School of Medicine, University of California, Los Angeles, discusses the pooled analysis of the REACH and REACH-2 studies in patients with hepatocellular carcinoma (HCC). Findings from this analysis were presented at the 2018 World Congress on GI Cancer.

Investigators conducted a pooled efficacy and safety analysis of ramucirumab (Cyramza) as a second-line treatment for patients with advanced HCC who had an elevated alpha-fetoprotein following first-line sorafenib (Nexavar) using data from 2 phase III studies, REACH and REACH-2. This analysis was done because the baseline population in REACH had very similar characteristics to the one accrued in REACH-2, Finn says.

The tolerability of ramucirumab differs from the kinase inhibitors, in that most of the adverse events are on-target effects from VEGF receptor inhibition such as hypertension. Although there was an increase in ascites, there was not an increase in significant bleeding events, notes Finn.

In the combined analysis, the absolute benefit shown in the control arm is an over 3-month survival, consistent to what has been seen with kinase inhibitors in this setting, Finn explains. The control arm in the REACH-2 study was quite small, so the combined analysis adds robustness to the observation that ramucirumab is improving outcomes for patients with HCC who have an elevated alpha-fetoprotein, Finn concludes.