Karen L. Reckamp, MD, Reviews Pembrolizumab Plus Ramucirumab in IO/Chemo Pretreated NSCLC at ASCO 2022

CancerNetwork® spoke with Karen L. Reckamp, MD, director of the Division of Medical Oncology and professor of Medicine at Cedar-Sinai Medical Center at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, about the Lung-MAP nonmatched phase 2 substudy S1800A (NCT03971474) in patients with advanced non–small cell lung cancer previously treated with immunotherapy and chemotherapy. Reckamp focused on the overall survival (OS) results in patients administered ramucirumab (Cyramza) plus pembrolizumab (Keytruda) vs standard of care.

Investigators observed an objective response rate of 22% (90% CI, 14%-30%) in the ramucirumab plus pembrolizumab arm and 28% (90% CI, 19%-37%) in the standard of care arm. Duration of response was 12.9 months (90% CI, 2.8-not reached) vs 5.6 months (90% CI, 4.6-7.8), respectively.

Transcript:

The reason we wanted to look at ramucirumab and pembrolizumab is we know that most patients receive immunotherapy [IO] early on in their [treatment] as first-line therapy and now even in early-stage disease patients. We also know that the majority will have tumor progression and develop resistance. We need to find ways to overcome that resistance and meet this critical unmet need. Using a combination of immunotherapy and VEGF receptor 2 inhibition, we have seen in previous early trials in IO-untreated patients that there are responses and that progression-free and overall survival can be prolonged. Based on that, we decided to move forward with this randomized phase 2 trial.

We found that the overall survival was improved with ramucirumab and pembrolizumab over the standard of care. The median overall survival was 14.5 months [80% CI, 13.9-16.1] vs 11.6 months [80% CI, 9.9-13.0] with the standard of care and the hazard ratio was 0.69 [80% CI, 0.51-0.91; P <.05]. This is important because in the standard of care arm, two-thirds of the patients received docetaxel and ramucirumab, which is the most active regimen we have right now in the refractory setting.

Reference

Reckamp KL. Overall survival from a phase II randomized study of ramucirumab plus pembrolizumab versus standard of care for advanced non–small cell lung cancer previously treated with immunotherapy: Lung-MAP nonmatched substudy S1800A. J Clin Oncol. 2022;40(suppl 16):9004. doi:10.1200/JCO.2022.40.16_suppl.9004