Many patients with advanced-stage gastric or gastro-oesophageal junction cancer (G/GEJC), particularly those deemed ineligible for combination therapy incorporating antibodies targeting HER2, PD-1 or claudin-18.2, receive chemotherapy alone in the first line. Disease progression typically occurs within a few months and the associated morbidities often preclude standard second-line treatment with ramucirumab plus paclitaxel. Now, results from the phase III ARMANI trial indicate that an early switch from induction chemotherapy to maintenance ramucirumab–paclitaxel improves outcomes.

In ARMANI, 280 patients with unresectable HER2-negative G/GEJC and disease control after 3 months of induction folinic acid, 5-fluorouracil and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin (CAPOX) were randomly assigned 1:1 to receive continuous ramucirumab–paclitaxel (switch maintenance group) or a further 3 months of FOLFOX or CAPOX followed by single-agent fluoropyrimidine maintenance (control group). The primary end point was progression-free survival (PFS).

许多晚期胃癌或胃食管结合部癌 （G/GEJC） 患者，尤其是那些被认为不适合结合靶向 HER2、PD-1 或 claudin-18.2 抗体的联合治疗的患者，在一线接受单独化疗。疾病进展通常发生在几个月内，相关的并发症通常排除了雷莫芦单抗加紫杉醇的标准二线治疗。现在，III 期 ARMANI 试验的结果表明，从诱导化疗早期转向维持雷莫芦单抗-紫杉醇可改善结果。

在 ARMANI 中，280 例诱导亚叶酸、5-氟尿嘧啶和奥沙利铂 （FOLFOX） 或卡培他滨和奥沙利铂 （CAPOX） 3 个月后疾病控制的不可切除 HER2 阴性 G/GEJC 患者被随机分配 1：1 接受连续雷莫芦单抗-紫杉醇（转换维持组）或再 3 个月的 FOLFOX 或 CAPOX，然后单药氟嘧啶维持治疗（对照组）。主要终点是无进展生存期 （PFS）。