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ASCO 2022: Second-Line Pembrolizumab Plus Ramucirumab in Advanced NSCLC

By: Kayci Reyer
Posted: Tuesday, June 7, 2022

According to research from the randomized, phase II Lung-MAP nonmatched substudy (S1800A), presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9004), a combination second-line treatment of the PD-1 inhibitor pembrolizumab plus ramucirumab (the monoclonal antibody targeted VEGFR2) improved survival outcomes compared with the standard of care for patients with advanced non–small cell lung cancer (NSCLC) who had previously received immune checkpoint inhibitor therapy. These findings were also simultaneously published in the Journal of Clinical Oncology.

“This is the first trial in the [second-]line setting without a chemotherapy backbone to demonstrate a potential survival benefit compared to [standard-of-care] regimens including docetaxel and ramucirumab using the Lung-MAP platform,” noted Karen L. Reckamp, MD, of Cedars-Sinai Medical Center, Los Angeles, and colleagues. Discussant of this abstract, Christine Bestvina, MD, of the University of Chicago, commented on these findings in the ASCO Daily News: “This combination has demonstrated efficacy in other malignancies including renal cell carcinoma, endometrial cancer, and hepatocellular carcinoma.”

Between May 2019 and November 2020, S1800A enrolled 137 eligible patients who had demonstrated disease progression during or after immune checkpoint inhibitor therapy, which they received for at least 84 days. Patients were randomly assigned to receive pembrolizumab plus ramucirumab or standard-of-care treatment. The investigator’s choice for the standard of care included docetaxel plus ramucirumab, docetaxel alone, pemetrexed, or gemcitabine.

Although median overall survival was significantly improved in the investigational arm (15 months) versus the standard-of-care arm (11.6 months), median progression-free survival was comparable for the two groups (4.5 months vs. 5.2 months, respectively). Improved overall survival among those receiving combination treatment was reported throughout most patient subgroups. The overall response rate was similar for both arms (P = .28).

Disclosure: For full disclosures of the study authors, visit coi.asco.org.


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