Key Points
• Conclusion: “DOC [docetaxel] plus RAM [ramucirumab] could be an optimal therapy for previous treated NSCLC patients with lung and liver metastasis, and furthermore, should be used carefully for patients with poor ECOG-PS [Eastern Cooperative Oncology Group-Prospective-Performance Status] or brain metastasis.”
• In the current study, Japanese researchers retrospectively assessed the ORR, DCR, and PFS in 237 patients who were administered docetaxel plus ramucirumab. The ORR was 25.2%, the DCR was 63.9%, and the median PFS was 4.5 months. Although malignant pleural effusion, lung metastasis, and liver metastasis did not predict shorter PFS, ECOG-PS 2+ and brain metastases did.
• The authors wrote, “Our study provides the most comprehensive set of data regarding the efficacy of DOC plus RAM in previously treated patients with NSCLC in a clinical setting. To the best of our knowledge, this is the first study that elucidates the relationship between metastatic site and therapeutic efficacy. Our findings demonstrate that poor ECOG-PS (≥2) and brain metastasis were independent factors significantly associated with a shorter PFS in patients who received DOC plus RAM. Furthermore, no differences in the PFS between patients with and without MPE and lung metastasis were found. There are several possible explanations as to why these differences in the PFS were observed in our study.”
• Limitations of the current study include biases due to its retrospective nature, as well as the potential for selection bias despite the use of multivariate models. Additionally, the investigators did not examine first-line and other lines of treatment before the initiation of DOC and RAM, thus potentially impacting OS. The investigators also did not compare the efficacy of DOC plus RAM on metastatic sites vs DOC monotherapy on metastatic sites. Lack of this comparison makes it challenging to infer the efficacy of RAM monotherapy.