Evidence map›Paper›PMID 36179540›Full record

Trial reportLung cancer (Amsterdam, Netherlands)2022

Ramucirumab plus atezolizumab in patients with stage IV non-small cell lung cancer previously treated with immune checkpoint inhibitors.

Brett H Herzog, Saiama N Waqar, Siddhartha Devarakonda, Jeffrey P Ward, Feng Gao, Ramaswamy Govindan, Daniel Morgensztern

Open access · greenAbstract readClinical Trial, Phase II
In one paragraph

Trial report in Lung cancer (Amsterdam, Netherlands), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 18% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Article
  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

7 authors at 2 institutions in 1 country.

Brett H HerzogAlvin Siteman Cancer Center and Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Saiama N WaqarAlvin Siteman Cancer Center and Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Siddhartha DevarakondaAlvin Siteman Cancer Center and Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Jeffrey P WardAlvin Siteman Cancer Center and Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Feng GaoCancer Center Biostatistics Core, Division of Public Health Sciences, Department of Surgery at Barnes-Jewish Hospital and Alvin Siteman Cancer Center, USA.
Ramaswamy GovindanAlvin Siteman Cancer Center and Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Daniel MorgenszternAlvin Siteman Cancer Center and Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: danielmorgensztern@wustl.edu.
Washington University in St. Louis · USJewish Hospital · US

Funding

Washington University Center for Cellular ImagingP30CA091842 · NCI · WASHINGTON UNIVERSITY · PI AIMEE S JAMES · 2001 to 2026
$128.0M
Washington University Paul Calabresi K12 Career Development Award for Clinical OncologyK12CA167540 · NCI · WASHINGTON UNIVERSITY · PI John F. Dipersio, Ramaswamy Govindan · 2012 to 2026
$11.7M
Supplement: Cancer-Cell and T-cell Dependent Regulation of Tumor Associated MacrophagesK08CA245215 · NCI · WASHINGTON UNIVERSITY · PI WARD, JEFFREY P · 2019 to 2023
$1.0M
NCI NIH HHS K08 CA245215NCI NIH HHS K12 CA167540NCI NIH HHS P30 CA091842
6 · The paper itself

Abstract

objectivesThe treatment options for patients with stage IV non-small cell lung cancer (NSCLC) who develop tumor progression after platinum-based chemotherapy and immune checkpoint inhibitors (ICIs) are limited. The combination of ICI with inhibitors of vascular endothelial growth receptor (VEGFR) signaling has shown promising results in previously untreated patients. MATERIALS AND

methodsIn this single institution phase II study, patients with advanced stage NSCLC previously treated with at least one line including ICI received ramucirumab 10 mg/kg and atezolizumab 1,200 mg intravenously every 21 days until tumor progression or intolerable toxicity. The primary endpoint was overall response rate (ORR) by the RECIST 1.1 criteria according to the investigator assessment. Secondary endpoints included clinical benefit rate (CBR), overall survival (OS), progression-free survival (PFS) and tolerability.

resultsTwenty-one patients were enrolled between June 2019 and April 2021. The median age was 67 (range 42-82), 17 (81 %) were female, and 15 (71 %) had non-squamous histology. The median number of prior systemic treatment lines and prior ICI lines were 3 (range 2-8) and 1 (range 1-3), respectively. One patient achieved a complete response for an ORR of 4.8 % while 16 (76.2 %) had stable disease with a CBR of 80.9 %. The median PFS was 3.4 months, and the median OS was 16.5 months. The most common adverse events included hypertension (86 %), proteinuria (67 %), and nausea (52 %). Grade 3 or 4 events were seen in 9 (43 %) of patients, with hypertension being the most common (33 %) of the grade 3 or 4 events.

conclusionsAlthough the primary endpoint of ORR was not met, the combination of ramucirumab plus atezolizumab was associated with a high CBR and the OS was better than expected in heavily pretreated patients. Therefore, further investigation with ICI plus VEGF inhibition is warranted.

Indexed as

Carcinoma, Non-Small-Cell LungHypertensionLung NeoplasmsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsFemaleHumansImmune Checkpoint InhibitorsMaleMiddle AgedRamucirumabVascular Endothelial Growth Factor AAntibodies, Monoclonal, HumanizedatezolizumabImmune Checkpoint InhibitorsRamucirumabVascular Endothelial Growth Factor AImmune checkpoint inhibitorNSCLCVEGF inhibition

Identifiers

PMID36179540
PMCPMC10401890
OpenAlexW4296934916

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.