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ESMO 2017 | RANGE study: Ramucirumab plus docetaxel improves PFS in advanced or metastatic urothelial cancer

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Daniel Petrylak

Ramucirumab plus docetaxel improves progression-free survival in patients with advanced or metastatic urothelial cancer who have progressed on platinum-based chemotherapy, according to results from the phase III RANGE trial presented at the ESMO 2017 Congress in Madrid.

“Ramucirumab reduced the risk of disease progression by 24% and this was consistent across patient subgroups,” said lead author Professor Daniel P. Petrylak, professor of medicine and urology, Yale School of Medicine and Yale Cancer Center, New Haven, CT, US. “The objective response rate nearly doubled with ramucirumab and there were no significant differences in toxicities between treatments.”

He concluded: “Ramucirumab plus docetaxel could become a standard of care in patients with platinum-refractory advanced or metastatic urothelial cancer who have either progressed on checkpoint inhibitors or are not eligible to receive them.”

Dr Richard Cathomas, deputy chief physician of oncology and haematology, Kantonsspital Graubünden, Chur, Switzerland, commented: “This is the first trial to show a progression-free survival benefit compared to chemotherapy alone in patients with platinum-refractory urothelial cancer. However, the magnitude of benefit was 1.3 months and, while statistically significant, it raises the question of whether it is clinically relevant.”
“We need to know if the improvement in progression-free survival translates into an overall survival benefit,” continued Cathomas. “We have seen from other trials combining chemotherapy with angiogenesis inhibitors in different cancers that such a small progression-free survival benefit often does not translate into overall survival.”

He concluded: “It is too early for these results alone to change the standard of care second line treatment, which is immune checkpoint inhibition. But the improvement in response rate shows that ramucirumab does have an impact on the disease, so in future, angiogenesis inhibition may become part of the treatment armamentarium for urothelial cancer.”

This session was recorded at the ESMO 2017 Congress in Madrid

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