Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 
Audrey Abella, 16 Oct 2017
The use of angiotensin converting enzyme (ACE) inhibitors may prevent repeat revascularization in patients who underwent percutaneous transluminal angioplasty (PTA) for peripheral artery disease (PAD) compared with angiotensin receptor blockers (ARB), according to a presentation at APCH 2017.

Ramucirumab combined with docetaxel outperforms chemotherapy alone for advanced bladder cancer

Dr. Joseph Delano Fule Robles
15 Sep 2017

Combination therapy with ramucirumab and docetaxel offers a progression-free survival (PFS) advantage over docetaxel alone in patients with advanced or metastatic urothelial carcinoma (UC), according to results of the phase III RANGE trial presented at the European Society of Medical Oncology  (ESMO) 2017 Congress held in Madrid, Spain.

The randomized, double-blind, international, multicentre trial included 530 patients with advanced or metastatic UC who progressed during or after platinum-based chemotherapy. A significant 24.3 percent improvement in PFS was shown in patients who received ramucirumab plus docetaxel vs placebo plus docetaxel (median, 4.07 vs 2.76 months; hazard ratio [HR], 0.757; p=0.0118). [Lancet 2017, doi: http://dx.doi.org/10.1016/S0140-6736(17)32365-6]

Investigator assessment of the PFS outcomes were also consistent among most patient subgroups.

Best overall response rate (24.5 vs 14 percent), complete (4.2 vs 1.4 percent) and partial (20.4 vs 12.7 percent) response rates were also higher among patients who received ramucirumab plus docetaxel vs placebo plus docetaxel.

The frequency of grade ≥3 adverse events were similar between the two groups (ramucirumab group, 60 percent; placebo group, 62 percent). The most common grade 3 adverse events with ramucirumab plus docetaxel were neutropenia (15 percent), febrile neutropenia (10 percent), fatigue (8 percent) and leukopenia (7 percent). In the placebo plus docetaxel group, the most common grade 3 adverse events were neutropenia (14 percent), anaemia (11 percent), fatigue (9 percent) and leukopenia (8 percent).

Mean scores for global quality of life were similar between the two groups, with no significant difference in time to sustained deterioration in global quality of life (non-stratified HR, 0.931; p=0.610).

“Ramucirumab plus docetaxel could become a new treatment option for patients with platinum-refractory advanced UC… The combination therapy did not result in significant additive toxicity or compromise quality of life when compared with placebo plus docetaxel,” said investigator Professor Daniel Petrylak of the Yale University School of Medicine, New Haven, Connecticut, US.  

“The strengths of the study are its ability to meet its primary endpoint, with best ORR reported in a phase III trial in unselected patients along with manageable side effects in this group of complex and frail patients,” commented discussant Dr Yohann Loriot of the Gustave Roussy, University of Paris Saclay, Villejuif, France.

“However, with only 10 percent of patients in the study having received prior immune checkpoint inhibitor [ICI] therapy, the question now is whether ramucirumab plus docetaxel will be active in patients in whom ICIs have no activity or whether ICIs would induce hyperprogression,” argued Loriot.

The overall survival data from this study was not presented due to immaturity. The data are expected to be reported in a separate interim analysis.

The RANGE trial was conducted as a follow-up on the successful phase II study in patients with platinum-refractory advanced or metastatic UC, which showed significant improvement in PFS with ramucirumab plus docetaxel compared with docetaxel alone (median, 5.4 vs 2.8 months; HR, 0.389; p=0.0002).[J Clin Oncol 2016;34:1500-1509]

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Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 
Audrey Abella, 16 Oct 2017
The use of angiotensin converting enzyme (ACE) inhibitors may prevent repeat revascularization in patients who underwent percutaneous transluminal angioplasty (PTA) for peripheral artery disease (PAD) compared with angiotensin receptor blockers (ARB), according to a presentation at APCH 2017.