Atezolizumab Plus VEGF Inhibition in Stage IV Lung Cancer
Posted: Monday, January 11, 2021
Preliminary data suggest that combination therapy using the VEGF receptor 2 antibody ramucirumab and atezolizumab is well tolerated and may improve survival among patients with stage IV non–small cell lung cancer (NSCLC). Researchers hypothesized that inhibiting VEGF signaling through its receptor using ramucirumab might increase intratumoral T cells. The study results were published in the Journal for ImmunoTherapy of Cancer by Brett Herzog, MD, PhD, of Washington University, St. Louis, and colleagues.
This report focused on the first 12 patients enrolled in the study, who all had advanced-stage NSCLC and had previously failed to respond to immune checkpoint blockers. Patients had been treated with an average of 3.5 prior lines of therapy and 1.6 lines of immunotherapy. Those with untreated brain metastases, recent hemoptysis, gastrointestinal bleeding or perforation, or fistula were excluded from the study.
Although no objective responses were recorded, 11 patients achieved stable disease. The median progression-free survival was 3 months, and notably, three patients remained on the trial for more than 12 months. The median overall survival at the data cutoff (September 15, 2020) was 11.5 months.
There were no grade 3 or 4 adverse events recorded, indicating treatment seemed to be well tolerated by patients. The most common adverse events were grade 1 or 2 hypertension (35%), nausea (25%), and vomiting (25%).
The trial is still enrolling patients, and further exploratory analyses are planned.
Disclosure: For authors’ disclosures, visit jitc.bmj.com.