Addition of ramucirumab enhances docetaxel efficacy in patients who had received anti-PD-1/PD-L1 treatment.

Docetaxel (DTX) efficacy increases in patients with non-small cell lung cancer (NSCLC) who had received anti-programmed cell death-1/ligand 1 (anti-PD-1/L1) therapy. However, the effect of ramucirumab (Ram) on DTX efficacy following anti-PD-1/L1 therapy is unknown. Here, we aimed to evaluate the effect of Ram on DTX efficacy following anti-PD-1/L1 therapy. This retrospective study included 99 patients with NSCLC, who were divided into those who had (pre-ICI group) or had not (no-ICI group) received anti-PD-1/L1 antibody before DTX. Both groups were then treated with DTX or DTX plus Ram (DTX/Ram). Patient characteristics were compared between the DTX and DTX/Ram groups and adjusted with inverse probability of treatment weighting using propensity scores and the following confounding variables: age, sex, performance status, smoking status, histology, driver mutation, and line of treatment. We compared DTX/Ram and DTX in terms of efficacy in both the pre-ICI and no-ICI groups. In the pre-ICI group, 18 and 21 patients received DTX and DTX/Ram, respectively. In the no-ICI group, 35 and 25 patients received DTX and DTX/Ram. In the no-ICI group, progression-free survival (PFS) and overall survival (OS) were not significantly different between DTX/Ram- and DTX-treated patients (median PFS, 2.6 versus 1.6 months; p = 0.30, median OS; 8.2 versus 8.0 months; p = 0.30). In the pre-ICI group, PFS was significantly longer in DTX/Ram-treated than in DTX-treated patients (median, 5.9 versus 2.8 months; p = 0.03). Hazard ratio for disease progression or death was 0.75 (95% confidence interval, 0.20-0.96). The OS of DTX/Ram-treated patients tended to be longer than that of DTX-treated patients (median, 19.8 versus 8.6 months; p = 0.10). DTX efficacy following anti-PD-1/L1 therapy may be enhanced by Ram. Further studies are needed to validate the efficacy of inhibiting the vascular endothelial growth factor pathway following anti-PD-1/L1 therapy.

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest MN has received honoraria from Ono Pharmaceutical, Bristol Myers Squibb, Pfizer, Chugai Pharmaceutical, Eli Lilly, Taiho Pharmaceutical, AstraZeneca, Boehringer-ingelheim, MSD, Novartis; and received research funding from MSD, Novartis, Ono Pharmaceutical, Chugai Pharmaceutical, Bristol Myers Squibb, Taiho Pharmaceutical, Eli Lilly, AstraZeneca, Pfizer, Astellas; and had consulting/advisory roles for　Novartis, Daiichi Sankyo Healthcare, Taiho Pharmaceutical, Bristol Myers Squibb, Boehringer-ingelheim, Ono Pharmaceutical, Eli Lilly, Chugai Pharmaceutical, AstraZeneca, Merck Serono, MSD, Pfizer. AG has received honoraria from Ono Pharmaceutical, Bristol Myers Squibb,Pfizer, Chugai Pharmaceutical, Taiho Pharmaceutical, Daiichi Sankyo Healthcare, KYORIN Pharmaceutical, Accuray Japan, Boehringer-ingelheim, MSD, AstraZeneca, Kyowa Kirin, Otsuka Pharmaceutical, Eisai; and received research funding from Nippon Kayaku. MS has received honoraria from Ono Pharmaceutical, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly, Taiho Pharmaceutical, AstraZeneca, Boehringer-ingelheim, MSD; and received research funding from Taiho Pharmaceutical, Chugai Pharmaceutical, Boehringer-ingelheim. NY has received honoraria from Ono Pharmaceutical,Taiho Pharmaceutical, MSD, Novartis, Bayer Yakuhin, and had consulting/advisory roles for　Chugai Pharmaceutical. KU has received honoraria from Ono Pharmaceutical, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly, AstraZeneca, Boehringer-ingelheim, and had consulting/advisory roles for　AstraZeneca, Chugai Pharmaceutical. SK has received honoraria from Chugai Pharmaceutical Co., Ltd., MSD K.K., Bristol-Myers Squibb, ONO Pharmaceutical, AstraZeneca. All remaining authors report no conflict of interest.