{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:18:14Z","timestamp":1788265094108,"version":"build-2803163510"},"reference-count":16,"publisher":"Becaris Publishing Limited","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Aim:<\/jats:bold>\n Fruquintinib (Fruq), a selective VEGFR 1\/2\/3 inhibitor, showed a significant progression-free survival (PFS) benefit in the Phase III FRUTIGA trial for advanced gastric\/gastroesophageal junction (G\/GEJ) adenocarcinoma. Ramucirumab (RAM), an anti-VEGFR2 antibody, demonstrated efficacy in the RAINBOW-Asia trial. This anchored matching-adjusted indirect comparison (MAIC) evaluated Fruq plus paclitaxel versus RAM plus paclitaxel as second-line therapy for G\/GEJ adenocarcinoma in the absence of head-to-head trials.\n Materials & methods:<\/jats:bold>\n Data from individual patients in the FRUTIGA study (N\u00a0=\u00a0703) and aggregated data from the RAINBOW-Asia study (N\u00a0=\u00a0440) were analyzed. Baseline characteristics were balanced using entropy balancing. The placebo plus paclitaxel (PBO\u00a0+\u00a0PTX) groups served as the common comparators. The primary outcome was PFS; secondary outcomes included overall survival, objective response rate (ORR) and disease control rate (DCR). Rates of treatment-emergent adverse events (TEAEs) were also compared as an exploratory outcome using an adjusted indirect risk difference. Sensitivity analyses included restricted mean survival time and simulated treatment comparison.\n Results:<\/jats:bold>\n After weighting (effective sample size\u00a0=\u00a0564), baseline covariates were balanced. The anchored MAIC demonstrated that Fruq\u00a0+\u00a0PTX significantly improved PFS compared with RAM\u00a0+\u00a0PTX (HR: 0.70; 95% CI: 0.51\u20130.96; p\u00a0=\u00a00.0280), corresponding to a 30% reduction in progression risk, with a significant restricted mean survival time benefit of 1.18\u00a0months at 20\u00a0months (95% CI: 0.08\u20132.27; p\u00a0=\u00a00.024). Fruq achieved significantly higher ORR (OR: 1.76, 95% CI: 1.16\u20132.68; p\u00a0=\u00a00.008) and DCR (OR: 1.94, 95% CI: 1.33\u20132.83; p\u00a0<\u00a00.001). Overall survival was similar (0.97; 95% CI: 0.73\u20131.30; p = 0.8640). Subgroup analyses showed PFS benefits with Fruq in patients with ECOG PS 1, peritoneal metastases and two or fewer metastatic sites. In sensitivity analysis, the simulated treatment comparison also suggested a PFS benefit for Fruq\u00a0+\u00a0PTX (HR: 0.40, 95% CI: 0.32\u20130.50; p\u00a0<\u00a00.0001). For any-grade TEAEs, the indirect comparison showed higher adjusted relative incidences of increased bilirubin with Fruq\u00a0+\u00a0PTX than with RAM\u00a0+\u00a0PTX (RD: 12.3%; 95% CI: 2.3\u201322.4%, p\u00a0<\u00a00.05) and of hypokalemia (RD: 9.0%; 95% CI: 1.5\u201316.4%, p\u00a0<\u00a00.05). For grade \u22653 TEAEs, the adjusted relative incidence of decreased body weight was higher with Fruq\u00a0+\u00a0PTX than with RAM\u00a0+\u00a0PTX (RD: 2.9%; 95% CI: 0.6\u20135.2%, p\u00a0<\u00a00.05). The adjusted relative incidences of increased AST, ALT and hypocalcemia were numerically lower in the fruquintinib group than in the RAM group.\n Conclusion:<\/jats:bold>\n This MAIC indicates that Fruq\u00a0+\u00a0PTX may be more effective than RAM\u00a0+\u00a0PTX in second-line advanced G\/GEJ adenocarcinoma, with potentially improved PFS, ORR and DCR, and similar overall survival. Safety analyses suggested generally comparable safety profiles across the two regimens. Fruq\u00a0+\u00a0PTX remains a valuable treatment option, offering important comparative evidence for clinical and health technology assessment decisions.\n <\/jats:p>\n \n Trial Registration:<\/jats:bold>\n Clinicaltrials.gov identifiers:\n NCT07144995<\/jats:ext-link>\n .\n <\/jats:p>","DOI":"10.57264\/cer-2026-0072","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:53:07Z","timestamp":1786535587000},"source":"Crossref","is-referenced-by-count":0,"title":["Matching-adjusted indirect comparison of fruquintinib versus ramucirumab in advanced gastric or gastroesophageal junction adenocarcinoma"],"prefix":"10.57264","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6240-4719","authenticated-orcid":false,"given":"Nan","family":"An","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou, China"},{"name":"Research Unit of Precision Diagnosis & Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou, China"},{"name":"Research Unit of Precision Diagnosis & Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jibin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis & Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijian","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianshu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Zhongshan Hospital Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Gobroad Cancer Hospital, China Pharmaceutical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shukui","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Nanjing Tianyinshan Cancer Hospital of China Pharmaceutical University (CPU), Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxian","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Harbin Medical University Cancer Hospital, Haerbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhendong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jufeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueyin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Chemotherapy Oncology, Anhui Provincial Hospital, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihua","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou, China"},{"name":"Research Unit of Precision Diagnosis & Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou, China"},{"name":"Research Unit of Precision Diagnosis & Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"issue":"3","key":"e_1_3_10_3_2","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray F","year":"2024","unstructured":"Bray F, Laversanne M, Sung H Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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