A Combination of Ramucirumab Plus Pembrolizumab Lengthened Survival For Some Lung Cancer Patients

CHANGSHA, China - June 28, 2022 - PRLog -- A study conducted under the Lung Cancer Master Protocol (Lung-MAP) found that when treated with a combination of ramuzumab (Cyramza) and Keytruda,  Patients with advanced NSCLC whose cancer progressed during prior immunotherapy lived significantly longer than when treated with one of the current standard therapies for this cancer.

The study, also known as S1800A, a division of the National Institutes of Health (NIH), and conducted at NCI's National Clinical Trials Network (NCTN) and the NCI Community Oncology Research Program (NCORP).

Pembrolizumab is a class of immunotherapy drugs called immune checkpoint inhibitors (ICIs), while ramucirumab is a vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor, a class of drugs that block the enzyme drug.

The randomized phase 2 S1800A study enrolled 136 eligible patients with stage IV or recurrent non-small cell lung cancer. These patients had previously received ICI therapy. In all cases, the patients' tumors eventually became resistant to these drugs and grew or spread before the patients were enrolled in the S1800A trial.

The trial rapidly accumulated and had a diverse population, in large part because of the strong rollout of the Lung-MAP primary screening protocol. Roy S. Herbst, MD, associate director of the Yale Cancer Center, founder and principal investigator of Lung-MAP, and senior author of the paper, commented, "The unique nature of the Lung-MAP public-private partnership, the breadth and breadth of NCI's NCTN and NCORP, Backed by the diverse nature, we are able to bring these new treatments to patients with advanced lung cancer nationwide at no cost—an important improvement in patient access."

Overall survival was the primary endpoint of the trial. Secondary endpoints included progression-free survival (PFS) and objective response rate (ORR). The researchers found no significant difference in PFS between the two groups (hazard ratio [80% confidence interval]: 0.86 [0.66-1.14]; median: 4.5 months in the ramucirumab plus pembrolizumab group, compared with standard care group) or ORR (22% vs. 28%).

Treatment-related adverse events (side effects) of grade 3 or higher occurred in 42% of patients in the ramucirumab plus pembrolizumab group and 60% of those in the standard-of-care group.

Treatment in the trial control group was chosen by physicians and patients from a group of four standard chemotherapy regimens: docetaxel plus ramucirumab, docetaxel alone, gemcitabine or pemetrexed. About two-thirds of patients receiving standard care received docetaxel and ramucirumab as the most aggressive treatments approved in this setting.

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