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Sequencing strategies with ramucirumab and docetaxel following prior treatments for advanced non-small cell lung cancer: a multicenter retrospective cohort study

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Abstract

Objectives

Ramucirumab (RAM) and docetaxel (DOC) are commonly used after first-line therapy for advanced non-small cell lung cancer (NSCLC). Therefore, we aimed to elucidate sequencing strategies of RAM and DOC following prior treatments, including immune checkpoint inhibitor (ICI), cytotoxic agent (CTx) alone, bevacizumab (BEV), and tyrosine kinase inhibitor (TKI).

Methods

We recruited patients with NSCLC who received RAM and DOC and compared the groups with and without prior ICI, CTx alone, BEV, and TKI, respectively. By tumor response to such treatments, the patients were further classified into “complete response (CR) + partial response (PR),” “stable disease,” and “progressive disease” groups, respectively. We compared RAM and DOC efficacy among these groups.

Results

In total, 237 patients were registered. In the group with prior ICI, the objective response rate and disease control rate were significantly higher than those without prior ICI (p = 0.012 and 0.028, respectively), and the median progression-free survival (PFS) was also significantly longer (p = 0.027). There were no significant differences in PFS between the groups with and without CTx alone, BEV, and TKI. Multivariate analysis revealed that prior ICI was an independent factor associated with better PFS. Furthermore, the prior ICI group with CR + PR significantly prolonged PFS compared to the group without prior ICI (p = 0.013).

Conclusion

RAM and DOC may be preferably administered after ICI, rather than after CTx alone, BEV, or TKI, and, furthermore, enhanced if the prior ICI has a favorable tumor response.

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Data availability

The authors state that they have full control over all primary data and that they agree to allow the journal to review their data if requested.

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Acknowledgements

We thank all the patients who participated in this study.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan

    Satoshi Tanizaki, Junji Uchida & Kiyonobu Ueno

  2. Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-Cho, Kita-Ku, Sakai City, Osaka, 591-8555, Japan

    Kinnosuke Matsumoto, Akihiro Tamiya, Yoshihiko Taniguchi, Yoshinobu Matsuda & Kyoichi Okishio

  3. Department of Respiratory Medicine, Osaka International Cancer Institute, Osaka, Japan

    Hayato Kawachi & Motohiro Tamiya

  4. Department of Respiratory Medicine, Osaka Habikino Medical Center, Osaka, Japan

    Takafumi Yanase & Hidekazu Suzuki

  5. Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan

    Kyoichi Okishio

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Contributions

(i) Conception and design: K. Matsumoto and S. Tanizaki; (ii) administrative support: A. Tamiya; (iii) provision of study materials or patients: K. Matsumoto, H. Kawachi, S. Tanizaki, and T. Yanase; (iv) collection and assembly of data: K. Matsumoto; (v) data analysis and interpretation: K. Matsumoto, S. Tanizaki, and A. Tamiya; (vi) manuscript writing: all authors; and (vii) final approval of manuscript: all authors.

Corresponding author

Correspondence to Akihiro Tamiya.

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Ethics approval

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study was reviewed and approved by the Institutional Review Board (IRB) (IRB No. 2020–034) of the National Hospital Organization Kinki-Chuo Chest Medical Center.

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Satoshi Tanizaki and Kinnosuke Matsumoto contributed equally to this manuscript.

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Tanizaki, S., Matsumoto, K., Tamiya, A. et al. Sequencing strategies with ramucirumab and docetaxel following prior treatments for advanced non-small cell lung cancer: a multicenter retrospective cohort study. Eur J Clin Pharmacol 79, 503–511 (2023). https://doi.org/10.1007/s00228-023-03452-0

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