20 Oct REVEL Trial of Ramucirumab Plus Docetaxel For Fast Progressing NSC Lung Cancer Demonstrates Promise
MedicalResearch.com Interview with:
Martin Reck, MD, PhD
Head of the Department of Thoracic Oncology
Head of the Clinical Trial Department
Department of Thoracic Oncology at the Lung Clinic
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is an urgent medical need to improve outcomes in pretreated patients with advanced non-small cell lung cancer (NSCLC), in particular those with fast progressing tumors.
The Phase 3 REVEL study, which included patients with nonsquamous and squamous forms of NSCLC, demonstrated improved overall survival (OS), progression‐free survival (PFS), and objective response rate (ORR) – independent of histology. This analysis confirmed efficacy – with improvement of ORR, PFS and OS – in poor prognosis patients with fast progressing tumors (after 9, 12 or 18 weeks) without additional toxicity or impact on Quality of Life compared to the intent-to-treat (ITT) population results of REVEL.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Among patients with NSCLC, there is a group of patients with a very poor prognosis due to fast progression of the tumor and no response to platinum-based chemotherapy. This seems to be the group of patients where results of randomized trials suggest that immunotherapy might not be the most effective treatment.
In contrast, ramucirumab in combination with docetaxel has shown consistent efficacy in this group of patients and represents an attractive treatment option. These results are in line with other trials investigating the combination of antiangiogenic treatment with chemotherapy.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: It will be important to understand the translational background of these findings in order to optimize selection of appropriate patients.
MedicalResearch.com: Is there anything else you would like to add?
Response: This concept of antiangiogenic treatment and tumor proliferation is of interest from another perspective. It is known that VEGF has a strong immunosuppressive effect mediated by multiple mechanisms. Therefore, combination of antiangiogenic compounds like ramucirumab and checkpoint inhibitors could substantially increase the efficacy of immunotherapy, in particular those patients with fast progressing tumors. This concept can be further evaluated in prospective trials.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
EFFECT OF 2L RAMUCIRUMAB AFTER RAPID TIME TO PROGRESSION ON 1L THERAPY: SUBGROUP ANALYSIS OF REVEL IN ADVANCED NSCLC
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Last Updated on October 20, 2017 by Marie Benz MD FAAD