This is ReachMD, and you’re listening to Closing the Gaps in NSCLC, sponsored by Lilly. On this episode, titled Exploring Combined Chemoimmunotherapy, we will hear from Dr. Howard Jack West from the Swedish Cancer Institute.
If there is a downside to a combined chemoimmunotherapy approach, it’s that you’ve now compressed 2 lines of therapy into 1, and this leaves fewer options to consider for once the patient has progressed on chemoimmunotherapy. Specifically, I would now say that the only evidence-based approach that has a proven survival benefit is docetaxel with or without ramucirumab, and so this is my leading approach outside of a clinical trial setting. Docetaxel, we’ve known about the data to support it for nearly 20 years, and it still holds fast as a treatment option with a couple of months’ survival benefit for a broad range of patients, and ramucirumab can add a modest survival benefit to that. I would say that I have more patients in the wake of chemoimmunotherapy becoming a standard of care as first line who are progressing and still have a very good performance status, and now I’m more inclined to use a combination of docetaxel with ramucirumab than I was previously. I always considered the combination an option but was less inclined to favor that for patients with a more marginal performance status, but with patients going through chemoimmunotherapy and having exhausted more options and often still having a very good performance status, I’m more inclined to favor a combination of docetaxel/ramucirumab now than I was 1 or 2 years ago.
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