ASCO 2019: Dual EGFR and VEGFR Blockade in Metastatic Lung Cancer
Posted: Wednesday, June 26, 2019
A combination treatment of the VEGFR2 antagonist ramucirumab plus the EGFR inhibitor erlotinib led to improved outcomes in patients with previously untreated metastatic non–small cell lung cancer (NSCLC), according to results from the phase III RELAY multinational trial. The study, which was presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9000), evaluated whether this dual pathway blockade would increase antitumor activity.
“[Ramucirumab plus erlotinib] led to superior [progression-free survival] in the first line [setting] of EGFR-mutant metastatic NSCLC,” concluded Kazuhiko Nakagawa, MD, PhD, of Kindai University Hospital in Japan, and colleagues.
A total of 449 patients with previously untreated metastatic NSCLC and an exon 19 deletion or L858R as well as no central nervous system metastasis were included in the study. They were randomly assigned 1:1 to receive either 150 mg/day of erlotinib plus 10 mg/kg of ramucirumab every 2 weeks or erlotinib plus a placebo. Overall, 77% of participants were Asian, 63% were female, and 54% had an exon 19 deletion.
Progression-free survival was longer with ramucirumab plus erlotinib (n = 224), at a median of 19.4 months versus 12.4 months with erlotinib plus placebo (n = 225). The ramucirumab plus erlotinib cohort also experienced an extended duration of response (18.0 months vs. 11.1 months).
Grade 3 or higher treatment-related adverse events were more common in the ramucirumab-plus-erlotinib group (72%) than in the placebo group (54%), with hypertension occurring most often (24% vs. 5%, respectively). One treatment-related death occurred in the ramucirumab-plus-erlotinib arm, whereas none occurred in the placebo group.
Disclosure: The study authors’ disclosure information may be found at coi.asco.org.
