Ramucirumab and the controversial role of α-fetoprotein in hepatocellular carcinoma
Mené sur 292 patients atteints d'un carcinome hépatocellulaire de stade avancé et présentant un taux d'alpha-fœtoprotéine supérieur ou égal à 400 ng/ml, cet essai de phase III évalue l'efficacité, du point de vue de la survie globale, et la toxicité du ramucirumab après l'échec d'un traitement par sorafénib (durée médiane de suivi : 7,6 mois)
In The Lancet Oncology, Andrew X Zhu and colleagues report the results of REACH-2, a placebo-controlled phase 3 trial of ramucirumab in patients with hepatocellular carcinoma and baseline
α-fetoprotein concentrations of 400 ng/mL or greater, who had previously received sorafenib. Median overall survival was significantly improved in the ramucirumab group compared with the placebo group (8
·5 months [95% CI 7·0–10·6] vs 7·3 months [5·4–9·1]; hazard ratio 0·710 [95% CI 0·531–0·949]; p=0·0199) at a median follow-up of 7·6 months (IQR 4·0–12·5). This work comes at a crucial time in view of the advent of several tyrosine-kinase inhibitors with positive outcomes in hepatocellular carcinoma, and should be congratulated.
The Lancet Oncology 2019