Ramucirumab in second‑line advanced colorectal cancer therapy: A study on therapeutic outcomes and hepatic sinusoidal platelet aggregation

Kimura,Keisuke; Katata,Yosuke; Umeda,Yuzo; Tanaka,Takehiro; Yano,Shuya; Yoshida,Kazuhiro; Fujiwara,Toshiyoshi; Mori,Yoshiko; Yamada,Takeshi; Nagasaka,Takeshi

doi:10.3892/ol.2024.14572

Ramucirumab in second‑line advanced colorectal cancer therapy: A study on therapeutic outcomes and hepatic sinusoidal platelet aggregation

This article is part of the special Issue: Molecular target and action mechanism of anti-cancer agents
Authors:
- Keisuke Kimura
- Yosuke Katata
- Yuzo Umeda
- Takehiro Tanaka
- Shuya Yano
- Kazuhiro Yoshida
- Toshiyoshi Fujiwara
- Yoshiko Mori
- Takeshi Yamada
- Takeshi Nagasaka
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Affiliations: Department of Gastroenterological Surgery, Okayama University Hospital, Okayama 700‑8558, Japan, Department of Clinical Oncology, Kawasaki Medical School Hospital, Kurashiki, Okayama 701‑0192, Japan, Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700‑8558, Japan, Department of Gastrointestinal and Hepato‑Biliary‑Pancreatic Surgery, Nippon Medical School, Tokyo 113‑8602, Japan
Published online on: July 15, 2024 https://doi.org/10.3892/ol.2024.14572
Article Number: 439
Copyright : © Kimura et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

The present study investigated the role of ramucirumab (RAM) in treating liver metastases (LMs) as a second‑line or salvage treatment in patients with advanced CRC. Of the 36 patients, 21 (58%) received RAM plus folinic acid, fluorouracil and irinotecan (FOLFIRI) as second‑line treatment, whereas 15 (42%) received it in a salvage setting. The median overall survival time was 23 months [95% confidence interval (CI), 12‑34 months] for those in the second‑line treatment group and 8 months (95% CI, 5‑19 months) for those in the salvage treatment group. Of the 36 patients, 14 (39%) underwent surgical resection of LMs during chemotherapy. A total of 6 patients underwent surgical resection for LMs for the first time during second‑line RAM plus FOLFIRI (RAM‑LM); of the remaining 8 patients, 6 underwent resection of LMs during first‑line bevacizumab (BEV)‑based chemotherapy (BEV‑LM). Immunohistochemical analysis of CD42b showed that the platelet aggregation score (CD42b score), which ranges from 0 (absence of deposition) to 3 (presence of linear deposition), tended to decrease with the increasing duration of treatment with both RAM and BEV. Although there was no significant difference in the mean duration of anti‑VEGF antibody treatment between the BEV‑LM and RAM‑LM groups, the median CD42b score was higher in the RAM‑LM group (median CD42b score, 3; range, 0‑3) compared with that in the BEV‑LM group (median CD42b score, 1; range, 0‑3; P=0.01), suggesting that RAM induces a different degree of platelet aggregation in liver sinusoids compared to BEV.

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