Ramucirumab and Trifluridine/Tipiracil or Paclitaxel for the Treatment of Patients With Previously Treated Advanced Gastric or Gastroesophageal Junction Cancer
Trial Parameters
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Brief Summary
This phase II trial studies the effect of the combination of ramucirumab and trifluridine/tipiracil or paclitaxel in treating patients with previously treated gastric or gastroesophageal junction cancer that has spread to other places in the body (advanced). Ramucirumab may damage tumor cells by targeting new blood vessel formation. Trifluridine/tipiracil is a chemotherapy pill and that may damage tumor cells by damaging their deoxyribonucleic acid (DNA). Paclitaxel may block cell growth by stopping cell division which may kill tumor cells. Giving ramucirumab and trifluridine/tipiracil will not be worse than ramucirumab and paclitaxel in treating gastric or gastroesophageal junction cancer.
Eligibility Criteria
Inclusion Criteria: * Age \>= 18 years * Histological or cytological confirmation of adenocarcinoma of the stomach or gastroesophageal junction * Have locally advanced unresectable or metastatic disease that has progressed =\< 180 days since last treatment * One or more measurable or nonmeasurable evaluable lesions per Response Evaluation Criteria in Solid Tumors (RECIST) * Planned for second line treatment defined by failing or were intolerant to previous standard chemotherapies containing one or more of the following agents: * Fluoropyrimidine (IV 5-FU or capecitabine) and platinum (cisplatin or oxaliplatin) * Trastuzumab in case of HER2-positive disease * NOTE: For the patients whose disease recurred =\< 168 days from the last dose of adjuvant anticancer chemotherapy, that adjuvant anticancer chemotherapy is counted as 1 prior chemotherapy line * Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1 * Ability to swallow oral medications * Absolute neutrophil count