Background:

Antiangiogenic agents have been shown to stimulate the immune system and cause synergistic effects with chemotherapy. Effects might be even stronger after immune-checkpoint-inhibitor (ICI) therapy. The purpose of this analysis was to evaluate the efficacy of ramucirumab plus docetaxel (R + D) as third-line treatment after failure of a first-line platinum-based chemotherapy and a second-line ICI treatment in patients with non-small-cell lung cancer (NSCLC) stage IV.

Methods:

Retrospective data were collected from 9 German thoracic oncology centers. Only patients who had received at least 1 cycle of third-line R + D were included. The numbers of cycles, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were investigated.

Results:

Sixty-seven patients met the criteria for inclusion. Third-line treatment with R + D achieved an ORR of 36% and a disease control rate (DCR) of 69%. Median PFS for third-line therapy was 6.8 months with a duration of response (DOR) of 10.2 months. A median OS of 29 months was observed from the start of first-line therapy with a median OS of 11.0 months from the start of third-line treatment. No unexpected toxicities occurred.

Conclusion:

R + D is a highly effective and safe third-line treatment after failure of second-line programmed cell death protein 1/programmed cell death-ligand 1 (PD1/PD-L1)-derived ICI therapy irrespective of NSCLC histology. As there may be synergistic effects of second- and third-line treatments, this sequence is a very suitable option for patients not treated with first-line ICI. In addition, R + D should continue to be investigated as a second-line treatment option after failure of chemotherapy plus ICI in the palliative first–line treatment.

中文翻译：

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多西他赛加雷莫芦单抗作为二线免疫检查点抑制剂治疗后的姑息性三线治疗对非小细胞肺癌 IV 期患者的疗效。

背景：

已显示抗血管生成剂可刺激免疫系统并与化疗产生协同作用。免疫检查点抑制剂 (ICI) 治疗后效果可能会更强。本分析的目的是评估雷莫芦单抗联合多西他赛（R + D）作为一线铂类化疗和二线 ICI 治疗失败后非小细胞癌患者三线治疗的疗效肺癌（NSCLC）IV期。

方法：

回顾性数据来自 9 个德国胸部肿瘤中心。仅包括接受过至少 1 个周期三线 R+D 的患者。研究了周期数、客观缓解率 (ORR)、无进展生存期 (PFS) 和总生存期 (OS)。

结果：

67 名患者符合纳入标准。R + D 三线治疗的 ORR 为 36%，疾病控制率 (DCR) 为 69%。三线治疗的中位 PFS 为 6.8 个月，缓解持续时间 (DOR) 为 10.2 个月。从一线治疗开始观察到的中位 OS 为 29 个月，从三线治疗开始的中位 OS 为 11.0 个月。没有发生意外的毒性。

结论：

无论 NSCLC 组织学如何，在二线程序性细胞死亡蛋白 1/程序性细胞死亡配体 1 (PD1/PD-L1) 衍生的 ICI 治疗失败后，R + D 是一种高效且安全的三线治疗。由于二线和三线治疗可能存在协同效应，因此该顺序对于未接受一线 ICI 治疗的患者来说是一个非常合适的选择。此外，在姑息性一线治疗中化疗加 ICI 失败后，应继续研究 R+D 作为二线治疗选择。