Efficacy and Safety of Docetaxel plus Ramucirumab for Patients with Pretreated Advanced or Recurrent Non-small Cell Lung Cancer: Focus on Older Patients

Keisuke Onoi; Tadaaki Yamada; Kenji Morimoto; Hayato Kawachi; Rei Tsutsumi; Takayuki Takeda; Asuka Okada; Nobuyo Tamiya; Yusuke Chihara; Shinsuke Shiotsu; Yoshizumi Takemura; Takahiro Yamada; Isao Hasegawa; Yuki Katayama; Masahiro Iwasaku; Shinsaku Tokuda; Koichi Takayama

doi:10.1007/s11523-024-01045-0

Efficacy and Safety of Docetaxel plus Ramucirumab for Patients with Pretreated Advanced or Recurrent Non-small Cell Lung Cancer: Focus on Older Patients

Target Oncol. 2024 Mar 11. doi: 10.1007/s11523-024-01045-0. Online ahead of print.

Authors

Keisuke Onoi¹, Tadaaki Yamada², Kenji Morimoto¹, Hayato Kawachi¹, Rei Tsutsumi³, Takayuki Takeda³, Asuka Okada⁴, Nobuyo Tamiya⁵, Yusuke Chihara⁶, Shinsuke Shiotsu⁷, Yoshizumi Takemura⁸, Takahiro Yamada⁹, Isao Hasegawa¹⁰, Yuki Katayama¹, Masahiro Iwasaku¹, Shinsaku Tokuda¹, Koichi Takayama¹

Affiliations

¹ Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
² Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. tayamada@koto.kpu-m.ac.jp.
³ Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
⁴ Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan.
⁵ Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan.
⁶ Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan.
⁷ Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
⁸ Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan.
⁹ Department of Respiratory Medicine, Matsushita Memorial Hospital, Osaka, Japan.
¹⁰ Department of Respiratory Medicine, Saiseikai Shigaken Hospital, Shiga, Japan.

PMID: 38467958
DOI: 10.1007/s11523-024-01045-0

Abstract

Background: Combination therapy with docetaxel (DTX) and ramucirumab (RAM) has been used as a second-line treatment for advanced or recurrent lung cancer. However, there is insufficient evidence regarding the safety of angiogenesis inhibitors in older patients.

Objective: This multicenter retrospective study aimed to investigate the efficacy and safety of second-line treatment regimens in older patients with advanced or recurrent non-small cell lung cancer (NSCLC).

Patients and methods: We retrospectively analyzed 145 patients aged ≥ 70 years with advanced or recurrent NSCLC treated with second-line chemotherapy after platinum-based therapy between April 1, 2016, and March 31, 2021. Patients were subdivided into the DTX + RAM (n = 38) and single-agent (n = 107) groups.

Results: The median time to treatment failure was 6.3 months (95% confidence interval [CI] 3.6-9.6) in the DTX + RAM group and 2.3 months (95% CI 1.7-3.0) in the single-agent group (p < 0.01). The median overall survival was 15.9 months (95% CI 12.3-Not Achieved) in the DTX + RAM group and 9.4 months (95% CI 6.9-15.1) in the single-agent group (p = 0.01). Grade ≥ 3 adverse events frequency was not significantly different between the two groups, except for edema. Patients in the DTX + RAM group who did not discontinue treatment owing to adverse events exhibited the most favorable prognosis.

Conclusions: These findings suggest that the DTX + RAM combination is an effective second-line therapy for older patients with advanced or recurrent NSCLC, offering favorable efficacy without treatment discontinuation owing to adverse events.