Evidence map›Paper›PMID 42919216›Full record

Trial reportBMC cancer2026

Reduced-dose nanoparticle albumin-bound-paclitaxel combined with ramucirumab as second-line treatment for advanced gastric cancer: a multicenter phase II study.

Michihisa Iida, Chiyo Nakashima, Toru Kawaoka, Junya Kondo, Tsunenori Yamamoto, Shigefumi Yoshino, Kazuhisa Tokuno, Takayuki Kuga, Koji Dairaku, Yuki Nakagami and 6 more

Abstract readClinical Trial, Phase IIMulticenter Study
PubMed Publisher
In one paragraph

Trial report in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Michihisa IidaDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan. miida@yamaguchi-u.ac.jp.
Chiyo NakashimaDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Toru KawaokaDepartment of Surgery, Tokuyama Central Hospital, Yamaguchi, Japan.
Junya KondoDepartment of Surgery, Ube Central Hospital, Yamaguchi, Japan.
Tsunenori YamamotoDepartment of Surgery, NHO Kanmon Medical Center, Yamaguchi, Japan.
Shigefumi YoshinoDepartment of Surgery, NHO Kanmon Medical Center, Yamaguchi, Japan.
Kazuhisa TokunoDepartment of Surgery, Tsushimi Hospital, Yamaguchi, Japan.
Takayuki KugaDepartment of Surgery, Nagato General Hospital, Yamaguchi, Japan.
Koji DairakuDepartment of Surgery, Onoda Municipal Hospital, Yamaguchi, Japan.
Yuki NakagamiDepartment of Data Science, Faculty of Data Science, Shimonoseki City University, Yamaguchi, Japan.
Yusaku WatanabeDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Hiroto MatsuiOncology Center, Yamaguchi University Hospital, Yamaguchi, Japan.
Yoshitaro ShindoDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Hidenori TakahashiDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Tatsuya IokaOncology Center, Yamaguchi University Hospital, Yamaguchi, Japan.
Hiroaki NaganoDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWeekly paclitaxel combined with ramucirumab is the standard second-line chemotherapy regimen for advanced gastric cancer. Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is increasingly used as it lowers the risk of hypersensitivity reactions; however, full-dose nab-paclitaxel (100 mg/m²) combined with ramucirumab frequently leads to severe myelosuppression. In clinical practice, dose reduction is often required, particularly in older patients or those with a poor performance status. However, the clinical efficacy and safety of a reduced-dose regimen of nab-paclitaxel combined with ramucirumab have not yet been prospectively evaluated. Accordingly, this multicenter phase II study aimed to assess the efficacy and tolerability of reduced-dose nab-paclitaxel combined with ramucirumab as second-line treatment for advanced gastric cancer.

methodsThis open-label, single-arm, multicenter phase II trial was conducted at nine institutions between March 2018 and August 2021 and enrolled 50 patients with unresectable or recurrent gastric or esophagogastric junction adenocarcinoma who had previously undergone treatment with fluoropyrimidine-based chemotherapy. Nab-paclitaxel (80 mg/m²) was administered intravenously on days 1, 8, and 15 in combination with ramucirumab (8 mg/kg) on days 1 and 15 of each 28-day cycle. The primary endpoint was progression-free survival. The secondary endpoints included overall survival, response rate, disease control rate, relative dose intensity, and safety. Tumor responses were assessed using the Response Evaluation Criteria in Solid Tumors v1.1.

resultsThe median progression-free survival was 5.8 months (95% confidence interval [CI], 4.6-7.0). The median overall survival was 12.5 months (95% CI, 10.6-14.5). Among patients with measurable lesions, the objective response rate was 33.3%, including one case of complete response. The disease control rate was 80%. Grade ≥ 3 neutropenia occurred in 50% of patients, whereas febrile neutropenia occurred in 2%. The relative dose intensity was 86.5% for nab-paclitaxel and 92.8% for ramucirumab.

conclusionsReduced-dose nab-paclitaxel combined with ramucirumab demonstrated modest efficacy and favorable tolerability as second-line chemotherapy for advanced gastric cancer. This regimen may represent a practical treatment alternative for patients deemed unsuitable for full-dose nab-paclitaxel due to concerns regarding its toxicity.

trial registrationThis study was registered in the UMIN Clinical Trials Registry on February 14, 2018 (UMIN000031285).

Indexed as

AdenocarcinomaAlbuminsAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsStomach NeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPaclitaxelRamucirumab130-nm albumin-bound paclitaxelAlbuminsAntibodies, Monoclonal, HumanizedPaclitaxelRamucirumabGastric cancerNab-paclitaxelPhase II trialRamucirumabSecond-line chemotherapy

Identifiers

PMID42919216

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.