Expert Point of View: Neal J. Meropol, MD and Johanna C. Bendell, MD

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Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University in Cleveland, commented that the quality of the data on ramucirumab is “very high,” and therefore, “we can believe these results.” The magnitude of the benefit, however, is “modest,” he pointed out. “This is not a home run, but ramucirumab is generally well tolerated, and for the patient with advanced cancer who is looking at toxic chemotherapy as their other treatment option, this may be preferable.”

He also noted that this study evaluated the drug as a single agent, and suggested that greater benefit might be achieved in combination with chemotherapy, as was demonstrated with trastuzumab.

The findings for the TyTAN study are encouraging for the HER2-enriched subset, he noted, and provide proof that “perturbing the HER2 pathway by means other than trastuzumab is of benefit.”

Need for Quality-of-life Data

Johanna C. Bendell, MD, Director of the GI Cancer Research Program at the Sarah Cannon Research Institute, Nashville, commented that clinical trials are showing survival improvements with second-line chemotherapy, and now with targeted therapy. “But the benefits are not huge, and we need to ask, ‘If we can help patients live longer, can we also help them live better?’ We need quality-of-life data for this. Also, can we select patients who will most likely benefit from additional treatment so we can appropriately triage them?’” she said. “We still have far to go, but we are making steps forward.” ■

Disclosure: Drs. Meropol and Bendell reported no potential conflicts of interest.

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