Evidence map›Paper›PMID 34928484›Full record

Trial reportDrug safety2022

RELAY, Ramucirumab Plus Erlotinib Versus Placebo Plus Erlotinib in Patients with Untreated, Epidermal Growth Factor Receptor Mutation-Positive, Metastatic Non-Small-Cell Lung Cancer: Safety Profile and Manageability.

Ernest Nadal, Hidehito Horinouchi, Jin-Yuan Shih, Kazuhiko Nakagawa, Martin Reck, Edward B Garon, Yu-Feng Wei, Jens Kollmeier, Bente Frimodt-Moller, Emily Barrett and 3 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Drug safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02411448 (A Multicenter, Randomized, Double-Blind Study of Erlotinib in Combination With Ramucirumab or Placebo in Previously Untreated Patients With EGFR Mutation-Positive Metastatic Non-Small Cell Lung Cancer), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02411448 phase3active not recruitingnot on this map

A Multicenter, Randomized, Double-Blind Study of Erlotinib in Combination With Ramucirumab or Placebo in Previously Untreated Patients With EGFR Mutation-Positive Metastatic Non-Small Cell Lung Cancer

TypeinterventionalSponsorEli Lilly and CompanyRan2015 to 2026Enrolled545ConditionsMetastatic Non-Small Cell Lung CancerArmsRamucirumab, Placebo, Erlotinib, Gefitinib, Osimertinib
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Expert consensus to optimize the management of older adult patients with advanced EGFR-mutated non-small cell lung cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023
    Article
  5. Review
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 12 institutions in 8 countries.

Ernest NadalCatalan Institute of Oncology, IDIBELL, L'Hospitalet, Barcelona, Spain. esnadal@iconcologia.net.ORCID 0000-0002-9674-5554
Hidehito HorinouchiNational Cancer Center Hospital, Tokyo, Japan.
Jin-Yuan ShihNational Taiwan University Hospital, Taipei City, Taiwan.
Kazuhiko NakagawaFaculty of Medicine, Kindai University, Osaka, Japan.
Martin ReckLungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany.
Edward B GaronDavid Geffen School of Medicine at UCLA/Translational Research in Oncology-US Network, Santa Monica, CA, USA.
Yu-Feng WeiE-Da Cancer Hospital, I-Shou University, Kaohsiung City, Taiwan.
Jens KollmeierHelios Klinikum Emil von Behring, Berlin, Germany.
Bente Frimodt-MollerEli Lilly and Company, Copenhagen, Denmark.
Emily BarrettEli Lilly and Company, Bracknell, UK.
Olga LipkovichEli Lilly and Company, Indianapolis, IN, USA.
Carla Visseren-GrulLilly Oncology, Utrecht, Netherlands.
Silvia NovelloDepartment of Oncology, University of Turin, A.O.U. San Luigi Gonzaga, Turin, Italy.
Eli Lilly (Netherlands) · NLEli Lilly (United Kingdom) · GBEli Lilly (United States) · USGerman Center for Lung Research · DEHelios Klinikum Emil von Behring · DEInstitut d'Investigació Biomédica de Bellvitge · ESI-Shou University · TWKindai University · JPNational Taiwan University Hospital · TWThe US Oncology Network · USTokyo National Hospital · JPUniversity of Turin · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRELAY was a global, double-blind, placebo-controlled phase III study that demonstrated superior progression-free survival (PFS) for ramucirumab plus erlotinib (RAM + ERL) versus placebo plus erlotinib (PBO + ERL) in the first-line treatment of patients with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 (L858R) mutation-positive, metastatic non-small-cell lung cancer (NSCLC).

objectiveThis article provides an in-depth analysis of the safety profile of RAM + ERL versus PBO + ERL observed in RELAY.

methodsEligible patients met these criteria: stage IV NSCLC; EGFR exon 19 deletion or exon 21 substitution (L858R) mutation; Eastern Cooperative Oncology Group performance status 0 or 1; and no central nervous system metastases. Patients were randomized (1:1) to receive erlotinib 150 mg/day orally plus either ramucirumab 10 mg/kg intravenously or matching placebo once every 2 weeks, until disease progression or unacceptable toxicity. The primary endpoint was PFS. Safety was evaluated based on reported treatment-emergent adverse events (AEs) and clinical laboratory assessments.

resultsThe safety population comprised 446 patients (221 in RAM+ERL arm; 225 in PBO + ERL arm) who received at least one dose of study drug between January 2016 and February 2018. The overall incidence of grade ≥ 3 AEs was higher with RAM + ERL than with PBO + ERL, primarily driven by grade 3 hypertension. Grade ≥ 3 dermatitis acneiform and diarrhea were also reported more frequently in the RAM + ERL arm. The increased incidence of AEs with RAM + ERL was easily detected through routine monitoring and managed through dose adjustments and appropriate supportive care.

conclusionThis in-depth safety analysis from RELAY supports that RAM + ERL, irrespective of the increased incidence of AEs, does not affect a patient's ability to benefit from treatment. CLINICAL TRIAL REGISTRATION NUMBER: NCT02411448.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsErbB ReceptorsErlotinib HydrochlorideHumansMutationRamucirumabAntibodies, Monoclonal, HumanizedErbB ReceptorsErlotinib HydrochlorideRamucirumab

Identifiers

PMID34928484
PMCPMC8763844
OpenAlexW4200561103

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.