New combination of drugs increases survival time for some patients with refractory lung cancer

A combination of the drugs ramucirumab and pembrolizumab reduced risk of death by 31% compared with the standard of care in patients with advanced non-small cell lung cancer that had progressed on prior immunotherapy.

Patients with advanced non-small cell lung cancer whose cancer had progressed on previous immunotherapy lived significantly longer when subsequently treated with a combination of ramucirumab and pembrolizumab than when treated with one of the current standard therapies for this type of cancer, according to a study conducted under the Lung Cancer Master Protocol (Lung-MAP) -; an NCI public-private partnership National Clinical Trials Network program led by founding and principal investigator. Dr. Roy S. Herbst, deputy director for clinical affairs at Yale Cancer Center.

The findings were presented June 3 at the 2022 Annual Meeting of the American Society of Clinical Oncology (ASCO) and published simultaneously in the Journal of Clinical Oncology. The study was co-led and presented at ASCO by Dr. Karen Reckamp, director of the Division of Medical Oncology and associate director of clinical research at Cedars-Sinai Medical Center in Los Angeles.

This trial shows that, with this combination of drugs, longer survival times are possible in patients with this type of refractory lung cancer even when other drugs have failed them."

Dr. Roy S. Herbst, senior author of the paper

The randomized phase 2 study enrolled 136 eligible patients with stage IV or recurrent non-small cell lung cancer. Patients receiving a current standard therapy had a mean overall survival (OS) time of 11.6 months, while the mean OS for those receiving a combination of ramucirumab and pembrolizumab was 14.6 months.

"While a phase 3 trial for this protocol is still needed to further examine its impact, these findings are extremely promising for a group of patients with limited treatment options," said Herbst. "While immunotherapy has revolutionized lung cancer therapy, when patients fail these drugs, there are few if any other positive trial results. This is among the very first."

The study, known as S1800A, was run as part of Lung-MAP, the first lung cancer precision medicine trial supported by the National Cancer Institute (NCI) -; which is part of the National Institutes of Health (NIH) -; and was conducted within the NCI's National Clinical Trials Network (NCTN) and the NCI Community Oncology Research Program (NCORP).

"The unique nature of the public–private partnership of Lung-MAP, supported by the expansive and diverse nature of the NCI's NCTN and NCORP, allowed us to bring these new therapies to patients with advanced lung cancer nationwide at no cost to patients -; an important improvement in patient access," said Herbst. "I am fortunate for the past eight years to have worked with such a wonderful interdisciplinary and national team to help patients with lung cancer throughout the United States."

S1800A was funded by the NIH/NCI through grants CA180888, CA180819, and CA180821, and in part by the Foundation for the National Institutes of Health, Eli Lilly and Company, and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc.