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The present study investigated the role of ramucirumab (RAM) in treating liver metastases (LMs) as a second‑line or salvage treatment in patients with advanced CRC. Of the 36 patients, 21 (58%) received RAM plus folinic acid, fluorouracil and irinotecan (FOLFIRI) as second‑line treatment, whereas 15 (42%) received it in a salvage setting. The median overall survival time was 23 months 95% confidence interval (CI), 12‑34 months for those in the second‑line treatment group and 8 months (95% CI, 5‑19 months) for those in the salvage treatment group. Of the 36 patients, 14 (39%) underwent surgical resection of LMs during chemotherapy. A total of 6 patients underwent surgical resection for LMs for the first time during second‑line RAM plus FOLFIRI (RAM‑LM); of the remaining 8 patients, 6 underwent resection of LMs during first‑line bevacizumab (BEV)‑based chemotherapy (BEV‑LM). Immunohistochemical analysis of CD42b showed that the platelet aggregation score (CD42b score), which ranges from 0 (absence of deposition) to 3 (presence of linear deposition), tended to decrease with the increasing duration of treatment with both RAM and BEV. Although there was no significant difference in the mean duration of anti‑VEGF antibody treatment between the BEV‑LM and RAM‑LM groups, the median CD42b score was higher in the RAM‑LM group (median CD42b score, 3; range, 0‑3) compared with that in the BEV‑LM group (median CD42b score, 1; range, 0‑3; P=0.01), suggesting that RAM induces a different degree of platelet aggregation in liver sinusoids compared to BEV.
Kimura et al. (Mon,) studied this question.