P3-076 - The efficacy and safety of Ramucirumab and FOLFIRI for the treatment of advanced/recurred colorectal cancer in late line

Abstract

Rumcirmab(Rmab) and FOLFIRI combination therapy approved for advanced or recurred colorectal cancer as second line last year. Rmab is fully humanized monoclonal antibody that targets the extracellular domain of vascular endothelial growth factoe 2(VEGF-2), the principal mediator of VEGF-A downstream effacts in cancer angiogenesis. Furthermore, Rmab dose not only inhibit VEGF-A but also inhibit VEGF-C and D. However, Bevacizumab(Bmab) specifically inhibits only VEGF-A extracellulary. Some investigator reported that resistant tumor of Bmab occur high level VEGF-C and D. If Rmab could inhibit downstream effects in cancer angiogenesis, its might be possible to get a response even late line. The efficacy and safety of Rmab and FOLFIRI asa late line therapy for patients with advanced or recurred colorectal cancer. These patients enrolled this study from June 2016 from present. Twelves patients (The patients number will be increase at JSMO meeting) recieved Rmab and FOLFIRI. The gender were 9 males and 3 females with median age of 70 years (48-77 years). Performance status (PS) was 0 of 5 patients and PS 1 of 7 aptients. The location of primary was ascending of 5, descending of 1, sigmoid of 4 and rectum of 2 patients, respectively. The median prior therapy was 3 (3-5 therapies). The median Rmab and FOLFIRI cycles was 7 (1-14+ courses). The response rate was 18% (PR 2, SD 6, PD 3, NE 1). The progression free survival and overall survival times are still estimating. In terms of adverse events, serious adverse events of grade 3 or higher seen among all patients were neutropenia of 2, thrombocytopenia of 2, fatigue of 2, diarrhea of 1 and DPD deficiency of 1 patient. We recognized that Rmab and FOLFIRI therapy is efficacy, safetu and tolerability for advanced or recurred colorectal cancer even late line chemotherapy. In future, we are planning to measure serum VEGF-A, C and D.