Paclitaxel + Ramucirumab (RAINBOW) — 2L gastric/GEJ

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Components	`DRUG-PACLITAXEL` `DRUG-RAMUCIRUMAB`

ID	`REG-PACLITAXEL-RAMUCIRUMAB-GASTRIC`
Type	Regimen
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-ESMO-GASTRIC-2024` `SRC-NCCN-GASTRIC-2025`

Notes

RAINBOW trial (Wilke 2014): 2L gastric/GEJ adenocarcinoma post-platinum/ fluoropyrimidine — paclitaxel + ramucirumab vs paclitaxel mOS 9.6 vs 7.4 mo (HR 0.81), PFS 4.4 vs 2.9 mo, ORR 28% vs 16%. Established as preferred 2L regimen per NCCN cat 1. REGARD trial showed single-agent ramucirumab benefit but combination preferred when tolerated. Hypertension + bleeding monitoring + 28-day pre/post-surgery hold mandatory.

Used By

Indication

IND-GASTRIC-METASTATIC-2L-RAMUCIRUMAB-PACLITAXEL - IND-GASTRIC-METASTATIC-2L-RAMUCIRUMAB-PACLITAXEL

Regimen

REG-TDXD-GASTRIC - Trastuzumab deruxtecan (T-DXd) — 2L+ HER2+ gastric (DESTINY-Gastric01)