Different efficacy of ramucirumab in patients with metastatic gastric and gastroesophageal junction cancer according to ECOG performance status

Yoon et al reported the first randomized, phase II trial of ramucirumab, an anti-vascular endothelial growth factor receptor-2 monoclonal antibody, as front-line therapy in patients with advanced adenocarcinoma of the esophagus or gastric/gastroesophageal junction [1]. Unfortunately, the addition of ramucirumab to front-line mFOLFOX6 did not improve progression-free survival (PFS) in these patients. We noted from the subgroup analysis of PFS in figure 3A that, although not statistically significant, ramucirumab shows improved efficacy in patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS)=1 compared with ECOG PS 0 (hazard ratio 0.88 and 1 respectively). Based on these findings, we extended this subgroup analysis to all ramucirumab data available from literature.