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Carlisle J, Liu Y, Leal T. Back to the Drawing Board: Overcoming Resistance to PD-1 Blockade. J Clin Oncol 2024:JCO2400280. [PMID: 38833649 DOI: 10.1200/jco.24.00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 06/06/2024] Open
Affiliation(s)
- Jennifer Carlisle
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA
| | - Yuan Liu
- Department of Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Ticiana Leal
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA
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Osta BE, Carlisle J, Steuer C, Pakkala S, Leal T, Dhodapkar M, Liu Y, Chen Z, Owonikoko T, Ramalingam S. A Phase 2 Study of Docetaxel, Ramucirumab, and Pembrolizumab for Patients With Metastatic or Recurrent Non-Small-Cell Lung Cancer (NSCLC) who Progressed on Platinum-Doublet and PD-1/PD-L1 Blockade. Clin Lung Cancer 2022; 23:e400-e404. [PMID: 35863963 DOI: 10.1016/j.cllc.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND There is an urgent and unmet need for more effective treatment options for patients with metastatic and recurrent non-small-cell lung cancer (NSCLC) who progressed on platinum-based therapy, immune checkpoint inhibitors (ICI), and targeted therapies. Currently, the combination of docetaxel (D) and ramucirumab (R) is the next best salvage therapy with a modest historical progression free survival (PFS) of 4.5 months and 6-month PFS rate of 37% predating the era of ICI use. Anecdotal reports in patients who progressed on ICI suggest a higher response rate to docetaxel compared to historical experience. Furthermore, tumor related angiogenesis promotes tumor growth and may contribute to immune escape in patients treated with ICI. Therapeutic combination with anti-angiogenic, ICI, and chemotherapy have independently demonstrated clinical efficacy without additive toxicities in NSCLC patients. PATIENTS AND METHODS This multicenter, single arm, open label, phase 2 study will evaluate the safety and preliminary efficacy of the combination of docetaxel 75 mg/m2, ramucirumab 10 mg/kg, and pembrolizumab 200 mg in up to 41 patients with metastatic or recurrent NSCLC after progression on concomitant or sequential platinum-based chemotherapy and ICI. This treatment will be given intravenously on the same day every 3 weeks until disease progression, occurrence of severe side effects, or no clinical benefit. The primary endpoint is 6-month PFS rate. CONCLUSIONS This is the first study to evaluate the safety and efficacy of ICI combined with docetaxel and ramucirumab. The findings could provide valuable information for developing new treatment strategies for NSCLC patients.
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Affiliation(s)
- Badi El Osta
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA.
| | - Jennifer Carlisle
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA
| | - Conor Steuer
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA
| | - Suchita Pakkala
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA
| | - Ticiana Leal
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA
| | - Madhav Dhodapkar
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA
| | - Yuan Liu
- Winship Cancer Institute of Emory University, Atlanta, GA; Department of Biostatistics and Bioinformatics at Rollins School of Public Health, Emory University, Atlanta, GA
| | - Zhengjia Chen
- Division of Epidemiology and Biostatistics, University of Illinois Cancer Center, Chicago, IL
| | - Taofeek Owonikoko
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA
| | - Suresh Ramalingam
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Winship Cancer Institute of Emory University, Atlanta, GA
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