Matching-adjusted indirect comparison of fruquintinib versus ramucirumab in advanced gastric or gastroesophageal junction adenocarcinoma

360 Background: Fruquintinib (FRU), a selective VEGFR 1/2/3 inhibitor, showed a significant PFS benefit in the phase 3 FRUTIGA trial (NCT03223376) for advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma. Ramucirumab (RAM), an anti-VEGFR2 antibody, demonstrated efficacy in the RAINBOW-Asia trial (NCT02898077). This anchored MAIC compared FRU plus paclitaxel with RAM plus paclitaxel as second-line therapy in G/GEJ adenocarcinoma, addressing the absence of head-to-head trials. Methods: Individual patient data (IPD) from FRUTIGA (N = 703) and aggregated data (AgD) from RAINBOW-Asia (N = 440) were analyzed. Baseline characteristics such as age, ECOG PS, metastasis status, and prior chemotherapy were adjusted using entropy balancing. The anchored approach used placebo groups as common comparators. Primary outcome included PFS; secondary outcomes encompassed OS, ORR, and DCR. Sensitivity analyses involved restricted mean survival time (RMST) analyses and simulated treatment comparison (STC). Results: After weighting with an effective sample size of 564 for FRUTIGA, baseline covariates were well-balanced (standardized mean differences