Efficacy and safety of ramucirumab and docetaxel in previously treated patients with squamous cell lung cancer: a multicenter retrospective cohort study.

Hayato Kawachi,Akihiro Tamiya,Motohiro Tamiya,Satoshi Tanizaki,Toru Kumagai,Takafumi Yanase,Kinnosuke Matsumoto

doi:10.1007/s10637-022-01214-w

Abstract

Ramucirumab plus docetaxel (RAM/DOC) therapy is currently the standard for previously treated advanced non-small cell lung cancer (NSCLC), irrespective of histology. However, in the clinical trial, only the first-line platinum-based chemotherapy refractory patients were enrolled and the eligible criteria was strict to avoid hemoptysis, especially in squamous cell NSCLC (Sq). Thus, the efficacy and safety data on ramucirumab for Sq in real-world settings after immune checkpoint inhibitors monotherapy or combination therapy approved as novel first-line therapy is lacking. We retrospectively analyzed previously treated patients with advanced NSCLC who underwent RAM/DOC therapy at four institutions. Clinical data on the initiation of RAM/DOC were collected from medical records. Treatment outcomes were assessed according to the Response Evaluation Criteria in Solid Tumors version 1.1. Incidence of pulmonary hemorrhage was assessed according to the Common Terminology Criteria for Adverse Events version 5.0. Overall, 237 patients with NSCLC were included and 38 (16%) had squamous cell carcinoma. There were no significant differences in median progression-free survival and overall survival between Sq and non-Sq patients (5.8months vs. 4.3months, P = 0.0937; 15.2months vs. 13.4months, P = 0.714, respectively). Of all patients, 13 (5%) developed pulmonary hemorrhage. According to histological analysis, there was no significant difference in pulmonary hemorrhage proportion between Sq and non-Sq cohorts (2/38 vs. 11/199, respectively, P = 0.947). For previously treated patients with Sq, the efficacy and safety of RAM/DOC therapy were confirmed in a real-world setting and were similar to non-Sq.

Highlights

Lung cancer is a major cause of cancer-related mortality worldwide [1]
Immune checkpoint inhibitors (ICIs) and programmed death 1 (PD-1) programmed death ligand 1 (PD-L1) axis and cytotoxic T-lymphocyte antigen 4 (CTLA-4) axis inhibitors have demonstrated outstanding efficacy for first-line treatment of metastatic Non-small cell lung cancer (NSCLC), and they have been established as novel standard treatment options for NSCLC [4,5,6,7,8,9,10,11,12]
A total of 237 previously treated patients with NSCLC were included in the study; 38 (16%) had squamous cell carcinoma on histology (Table 1)

Summary

Introduction

Non-small cell lung cancer (NSCLC) accounts for approximately 80% of all lung cancer cases, with the majority of NSCLC cases being diagnosed at advanced, unresectable, and metastatic disease stages [2]. Systemic chemotherapy is the standard anticancer treatment for advanced metastatic NSCLC. Genetic and genomic profiling has developed, and advancements in molecular targeted therapies have improved the prognosis of patients with NSCLC [3]. Immune checkpoint inhibitors (ICIs) and programmed death 1 (PD-1) programmed death ligand 1 (PD-L1) axis and cytotoxic T-lymphocyte antigen 4 (CTLA-4) axis inhibitors have demonstrated outstanding efficacy for first-line treatment of metastatic NSCLC, and they have been established as novel standard treatment options for NSCLC [4,5,6,7,8,9,10,11,12]. Second-line chemotherapy after PD as first-line treatment is still important as salvage therapy

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Results

Conclusion