DOI: 10.1177/11795549261504626 ISSN: 1179-5549

Erlotinib Plus Ramucirumab Therapy After Osimertinib Treatment: A Multicenter Observational Study

Kosuke Hamai, Yuka Kato, Kenichi Chikamori, Nobuhisa Ishikawa, Shoichi Kuyama, Kakuhiro Yamaguchi, Kenichiro Kudo, Hiroyasu Shoda, Koji Inoue, Yoshifumi Nishimura, Nagio Takigawa, Shoichiro Yamamoto, Mari Uno, Naoki Kinoshita
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Background

Although osimertinib is widely used and is the most recommended drug worldwide for epidermal growth factor receptor (EGFR) -mutated lung cancer, treatment strategies post-osimertinib failure remain unclear. A previous report showed that if administered to patients previously treated with EGFR-tyrosine kinase inhibitors (TKIs), erlotinib or gefitinib plus bevacizumab resulted in an objective response rate (ORR) of 13%, disease control rate (DCR) of 88%, median progression-free survival (PFS) of 4.1 months, and median overall survival (OS) of 13.5 months. However, the efficacy of erlotinib plus ramucirumab therapy in patients previously treated with EGFR-TKIs has not been reported.

Methods

This retrospective study was designed to exploratorily evaluate the efficacy and safety of erlotinib plus ramucirumab therapy after osimertinib treatment in clinical practice. Forty-three patients with EGFR -mutated lung cancer were enrolled from 14 centers. The primary endpoint was PFS of erlotinib plus ramucirumab therapy. The secondary endpoints were time to treatment failure (TTF), OS, ORR, DCR, and safety of erlotinib plus ramucirumab therapy.

Results

The median PFS for erlotinib plus ramucirumab therapy was 7.1 months, median TTF 4.8 months, median OS 14.4 months, ORR 31.7%, and DCR 87.8%. In the group in which osimertinib was discontinued because of disease progression, the median PFS was 3.8 months and one-year PFS rate was 19.0%. In the group in which osimertinib was discontinued owing to adverse events, the median PFS was 11.1 months and one-year PFS rate was 48.3%, and treatment was continued without serious adverse events.

Conclusions

Erlotinib plus ramucirumab therapy may be a promising treatment option for patients with EGFR -mutated lung cancer who received initial treatment with osimertinib, especially in cases in which osimertinib was discontinued owing to adverse events.

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