Evaluating the effectiveness and safety of ramucirumab and pembrolizumab versus standard of care in previously treated patients with advanced NSCLC.

This study investigated the effectiveness and safety outcomes of ramucirumab (Cyramza) and pembrolizumab (Keytruda) versus standard of care (SOC) in previously treated patients with advanced non-small cell lung cancer (NSCLC). The data showed that ramucirumab and pembrolizumab significantly improved overall survival compared with SOC in these patients.

NSCLC is the most common form of lung cancer. It is responsible for around 85% of all lung cancer cases worldwide. Standard treatment for advanced NSCLC involves surgical removal of tumors, chemotherapy, and radiotherapy.

Immunotherapy has been found to be effective in advanced NSCLC. Immune checkpoint inhibitors are a type of immunotherapy used to treat a wide variety of cancers. Tumor cells try to avoid being killed by switching off our immune system. ICI work by blocking the off switch of the immune system. Pembrolizumab is an ICI that works by inhibiting (blocking) PD-1, an important protein in the immune system. This inhibition triggers the immune system to attack tumor cells and kills them. However, resistance to immunotherapy ultimately develops in patients and this can be difficult to treat.

Ramucirumab is a targeted therapy. It works by blocking the production of new blood vessels that are needed for cancer to grow and spread. The effectiveness and safety of combining ramucirumab and pembrolizumab versus SOC therapy in previously treated patients with advanced NSCLC are still unknown.

This study involved 136 patients with advanced NSCLC. All patients were previously treated with chemotherapy and immunotherapy. Patients were randomly assigned into 2 groups. Group 1 included 69 patients who received ramucirumab and pembrolizumab. Group 2 included 67 patients who received SOC therapy.

The average overall survival for group 1 was 14.5 months versus 11.6 months for group 2. Patients in group 1 were 31% more likely to have a better survival compared to patients in group 2.  

The average survival without cancer worsening for group 1 was 4.5 months versus 5.2 months for group 2. This difference was not considered statistically significant.

42% of the patients in group 1 experienced treatment-related side effects compared to 60% of the patients in group 2.

This study concluded that ramucirumab and pembrolizumab significantly improved overall survival compared with standard of care in patients with advanced NSCLC previously treated with chemotherapy and immunotherapy.

The sample size was very small. This study was funded by Eli Lilly and Company and Merck Sharp & Dohme Corp, the manufacturers of ramucirumab and pembrolizumab respectively.