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ASCO GI 2022 | HER-RAM: investigating trastuzumab, ramucirumab and paclitaxel for the second-line treatment of GC

Sun Young Rha, MD, PhD, Yonsei Cancer Center, Seoul, South Korea, discusses the updated results from the Phase Ib/II HER-RAM (NCT04888663) study. The HER-RAM trial investigated the second-line treatment of patients with HER2-positive advanced gastric or gastroesophageal junction (GEJ) cancer with trastuzumab, ramucirumab, and paclitaxel. Dr. Rha explains how most data on treating patients with HER2-positive gastric cancer (GC) are derived from first-line investigations in which approximately 70% of patients continue to exhibit HER2 expression. As there was no prospective data exploring the continuation of HER2 targeting in the second-line treatment for this patient population, of which ramucirumab plus paclitaxel is the current standard of care (SOC), the Phase Ib/II study was designed to investigate the addition of trastuzumab to this second-line combination. Phase I of the trial defined safety and tolerable dosing of the combination and Phase II of the study evaluated its efficacy. 50 patients were recruited to Phase II of the HER-RAM trial, demonstrating a significant benefit. A progression-free survival (PFS) rate of over 7 months was observed as well as a highly impressive overall survival (OS) rate of 13.6 months, considering that the majority of second-line studies have not exhibited an OS of greater than 7-8 months. Thus, it was concluded that the regimen of adding trastuzumab to ramucirumab plus paclitaxel holds great potential to improve the OS of this patients population. Although HER2 is currently the only biomarker being explored in patients with GC and GEJ, Dr Rha expect there will be many more to come in selecting subgroups of patients for various treatment regimens. This interview took place at the American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium.