Efficacy of docetaxel plus ramucirumab as palliative second-line therapy following first-line chemotherapy plus immune-checkpoint-inhibitor combination treatment in patients with non-small cell lung cancer (NSCLC) UICC stage IV
| Autor: | Wolfgang M. Brueckl, Gunther H. Wiest, C. Wesseler, Amanda Tufman, Petra Hoffknecht, Eckart Laack, Martin Reck, Jens Kollmeier, Achim Rittmeyer, Fabian Reich, Petros Christopoulos, Bernhard Ulm, Joachim H. Ficker, Albrecht Stenzinger |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
Chemotherapy medicine.medical_specialty business.industry medicine.medical_treatment non-small cell lung cancer (NSCLC) medicine.disease medicine.disease_cause Angiogenesis inhibitor Ramucirumab Docetaxel Internal medicine medicine Clinical endpoint Original Article KRAS Lung cancer business medicine.drug |
| Zdroj: | Transl Lung Cancer Res |
| ISSN: | 2218-6751 |
| Popis: | Background Chemotherapy plus immune-checkpoint inhibitor (CTx+ICI) therapy has become the preferred 1st line treatment in patients with metastatic NSCLC without oncogenic driven mutations. However, the optimal subsequent 2nd line treatment is not defined and several alternatives exist. The purpose of this analysis was to evaluate the efficacy of 2nd line docetaxel plus ramucirumab (D+R) initiated after failure of 1st line CTx+ICI. Methods Retrospective data were collected during routine care from German thoracic oncology centers. Only patients who had received at least one course of 2nd line D+R were included. ORR, PFS, OS and numbers of courses of D+R were investigated with PFS after initiation of D+R being the primary endpoint. Results Seventy-seven patients met the inclusion criteria. 2nd line treatment with D+R achieved an ORR and DCR of 32.5% and 62.4%, respectively. Median PFS for 2nd line therapy was 3.9 months with a DOR of 6.4 months. Median OS of 15.5 and 7.5 months were observed from the start of 1st line therapy and 2nd line treatment, respectively. No unexpected toxicities occurred. Presence of KRAS mutations was associated with significantly worse median PFS to D+R (2.8 vs. 4.5 months in wild-type cases; P=0.021) and was an independent predictor of inferior PFS in multivariate analysis. Conclusions D+R is an effective and safe 2nd line treatment after failure of 1st line CTx+ICI irrespective of NSCLC histology. However, patients with a KRAS mutation did not benefit from D+R in terms of PFS and will require further investigations. |
| Databáze: | OpenAIRE |
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