Ramucirumab plus pembrolizumab versus standard of care for advanced NSCLC after failure of immunotherapy

Resistance to immune checkpoint inhibition (ICI) in advanced non-small cell lung cancer represents a major unmet need. Combining ICI with VEGF/VEGFR inhibition has yielded promising results in multiple tumor types. The randomized phase II Lung-MAP S1800A substudy randomized advanced NSCLC patients previously treated with ICI and platinum-based chemotherapy to ramucirumab plus pembrolizumab (RP) or investigator’s choice of standard of care (SOC). The median overall survival was longer with RP compared with SOC. Investigator-assessed progression-free survival and response rates were similar between arms. Grade ≥ 3 treatment-related adverse events occurred in 42% of patients with RP and 60% with SOC.