Outcomes of Treatment for Advanced Gastric Cancer in Korean Patients Treated With Ramucirumab + Paclitaxel: A Nationwide Real-World Data

OBJECTIVES: According to the 2022 Statistics Korea report, cancer is the leading cause of death in Korea. Lung cancer has the highest mortality rate (22.3% of all cancer deaths), followed by liver (12.2%), colorectal (11.0%), pancreatic (8.8%), and gastric cancer (8.6%). Ramucirumab + paclitaxel is a common second-line therapy for advanced gastric cancer, but real-world evidence in Korean patients is limited. The purpose of this study is to identify the median overall survival of patients with advanced gastric cancer treated with ramucirumab + paclitaxel using claims data from the Health Insurance Review and Assessment Service.

METHODS: The study included all gastric cancer patients who received ramucirumab plus paclitaxel between May 1, 2018, and December 31, 2018. We analyzed overall survival periods for those covered by health insurance from May 1, 2018, to September 30, 2019. Kaplan-Meier and Cox proportional hazards models were used for survival analysis, comparing survival based on gender, type of health insurance, and surgery history.

RESULTS: A total of 1,419 patients were included, with 1,023 deaths. The median overall survival was 240 days (95% CI 229-259). Median survival showed no significant differences based on gender (males: 222 days, 95% CI 229-267; females: 218 days, 95% CI 213-264) or type of health insurance (general: 240 days, 95% CI 228-259; medical aid: 242 days, 95% CI 191-353). However, survival varied by surgery history (no surgery: 199 days, 95% CI 183-219; with surgery: 237 days, 95% CI 266-293).

CONCLUSIONS: Korea's health insurance claims data provide nationwide real-world data under a single-payer system, enabling the tracking of mortality for anticancer drugs despite hospital changes. Limited detailed clinical data prevented progression-free survival analysis. Linking hospital records with claims data is essential for accurate assessment