The following is a summary of “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” published in the November 2022 issue of Clinical Lung Cancer by Osta et al.

In the case of patients with metastatic or recurrent non–small-cell lung cancer (NSCLC) who have already tried platinum-based therapy, immune checkpoint inhibitors (ICI), and targeted treatments without success, there is an immediate and unfulfilled demand for more effective treatment alternatives. The next best salvage therapy is a combination of docetaxel (D) and ramucirumab (R), which has a moderate historical progression free survival (PFS) of 4.5 months and a 6-month PFS rate of 37% before the era of ICI usage. Patients who had previously progressed on ICI have shown a greater response rate to docetaxel, according to anecdotal accounts. Additionally, tumor-related angiogenesis encourages tumor growth and might lead to immune escape in patients treated with ICI. Patients with NSCLC benefit from anti-angiogenic, ICI, and chemotherapy combinations without experiencing any additional side effects.

Up to 41 patients with metastatic or recurrent NSCLC who have progressed on concomitant or sequential platinum-based chemotherapy and ICI will participate in this multicenter, single-arm, open-label, phase 2 study to assess the safety and preliminary efficacy of the combination of docetaxel 75 mg/m2, ramucirumab 10 mg/kg, and pembrolizumab 200 mg. Each intravenous dose will be administered on the same day of the week every 3 weeks until disease progression, significant adverse effects, or a lack of therapeutic benefit occur. The rate of progression-free survival at 6 months is the primary endpoint.

To their knowledge, this is the first research to assess the feasibility and efficacy of ICI in tandem with docetaxel and ramucirumab. The results may be useful for guiding the creation of novel NSCLC treatment plans.