Phase 2 study of docetaxel plus ramucirumab after immunotherapy in advanced non-small cell lung cancer

Docetaxel plus ramucirumab (DTX+RAM) is a standard second-line treatment for advanced non-small cell lung cancer (aNSCLC). Prior immune checkpoint inhibition (ICI) therapy has been suggested to potentially affect the efficacy of subsequent DTX+RAM, but prospective evidence is limited. The phase 2 DRUN study at Wakayama Medical University (Japan) evaluated the combination in 33 aNSCLC patients progressing after ICI therapy. The objective response rate was 33.3% (90% CI 19.9-49.1) and the disease control rate was 90.9% (78.1-97.5). The median follow-up was 32.4 months (range 3.0-46.4). The median progression-free survival and overall survival were 4.9 months (95% CI 4.4-6.2) and 11.8 months (9.8-18.8), respectively. No new safety signals were observed. Patients who had responded to prior ICI therapy had longer progression-free survival than those who had not responded (HR 0.34; 95% CI 0.14-0.76). The authors conclude that DTX+RAM demonstrated antitumor activity in aNSCLC previously treated with ICI, with a manageable safety profile.