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Potential Predictive Biomarker for Ramucirumab Efficacy in Colorectal Cancer

By: Celeste L. Dixon
Posted: Monday, June 4, 2018

The results of the double-blind phase III RAISE trial previously indicated the addition of ramucirumab (versus placebo) to the chemotherapy regimen FOLFIRI significantly improved outcomes in patients receiving second-line treatment for metastatic colorectal cancer. The investigative team, led by Josep Tabernero, MD, PhD, of Vall d’Hebron Institute of Oncology, Barcelona, has released further results showing the biomarker VEGF-D as potentially predictive of response to ramucirumab (a monoclonal antibody that binds to VEGFR-2) in this patient population.

“Development of an assay appropriate for testing in clinical practice is currently ongoing,” wrote Dr. Tabernero and colleagues in the Annals of Oncology.

In the global RAISE trial, ramucirumab or placebo was given along with FOLFIRI (leucovorin, fluorouracil, irinotecan ) to 1,072 randomized patients with metastatic colorectal cancer. Of them, biomarker results were available for more than 80% of patients.

Dr. Tabernero and colleagues determined “a VEGF-D level of 115 pg/mL was appropriate for high/low subgroup analyses.” The high VEGF-D subgroup in the ramucirumab arm experienced a significant overall survival benefit of 2.4 months versus placebo (13.9 vs. 11.5 months), whereas the equivalent low VEGF-D subgroup experienced a decrease of 0.5 month (12.6 vs. 13.1 months).

“[Progression-free survival] results were consistent with [overall survival],” the researchers noted, adding that “no trends were evident with the other antiangiogenic candidate biomarkers.”

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