Highlights
- •The response rate for docetaxel plus ramucirumab (RD) after chemo-immunotherapy was 28.8%.
- •Progression free survivaland overall survival for RD after chemo-immunotherapy were 4.1 months and 11.6 months, respectively.
- •The frequency of pneumonitis due to RD after chemo-immunotherapy was 10.8%.
- •Bone metastasis, poor performance status and non-adenocarcinoma were prognostic factors for poor overall survival .
Abstract
Background
Ramucirumab plus docetaxel (RD) is a promising treatment for previously treated advanced
non-small cell lung cancer (NSCLC). However, its clinical significance after platinum-based
chemotherapy plus programmed death-1 (PD-1) blockade remains unclear.
Research question
What is the clinical significance of RD as a second-line treatment after the failure
of chemo-immunotherapy in NSCLC?
Study design and methods
In this multicentre retrospective study, 288 patients with advanced NSCLC who received
RDas second-line therapy after platinum-based chemotherapy plus PD-1 blockade, at
62 Japanese institutions from January 2017 to August 2020, were included. Prognostic
analyses were performed using the log-rank test. Prognostic factor analyses were performed
using a Cox regression analysis.
Results
A total of 288 patients were enrolled: 222 were men (77.1%), 262 were aged <75 years
(91.0%), 237 (82.3%) had smoking history and 269 (93.4%) had a performance status
(PS) of 0–1. One hundred ninety-nine patients (69.1%) were classified as adenocarcinoma
(AC) and 89 (30.9%) as non-AC. The types of PD-1 blockade used in the first-line treatment
were anti-PD-1 antibody and anti-programmed death-ligand 1 antibody in 236 (81.9%)
and 52 (18.1%) patients, respectively. The objective response rate for RD was 28.8%
(95% confidence interval [CI], 23.7–34.4). The disease control rate was 69.8% (95%
CI, 64.1–75.0).The median progression free survival and overall survival were 4.1
months (95% CI, 3.5–4.6) and 11.6 months (95% CI, 9.9–13.9), respectively. In a multivariate
analysis, non-AC and PS 2–3 were independent prognostic factors for worse progression
free survival , while bone metastasis on diagnosis, PS 2–3 and non-AC were identified
as independent prognostic factors for poor overall survival.
Interpretation
RD is a feasible second-line treatment in patients with advanced NSCLC who had received
combined chemo-immunotherapy with PD-1 blockade.
Clinical trial registration number
UMIN000042333.
Keywords
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Article info
Publication history
Published online: February 10, 2023
Accepted:
January 26,
2023
Received in revised form:
December 26,
2022
Received:
November 5,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
