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Association details:
Evidence:
Evidence Level:
Sensitive: A1 - Approval
Source:
Published date:
04/21/2014
Excerpt:
CYRAMZA® is a human vascular endothelial growth factor receptor 2 (VEGFR2) antagonist indicated:...in combination with erlotinib, for first-line treatment of metastatic non-small cell lung cancer with epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) mutations.
Evidence Level:
Sensitive: A2 - Guideline
New
Source:
Excerpt:
EGFR EXON 19 DELETION OR L858R MUTATIONS….Progression on erlotinib (± ramucirumab or bevacizumab), afatinib, gefitinib, or dacomitinib….SUBSEQUENT THERAPY...Continue erlotinib (± ramucirumab or bevacizumab) or afatinib or gefitinib or dacomitinib (if T790M-).
Evidence Level:
Sensitive: B - Late Trials
Title:

Efficacy and Tolerability of Ramucirumab Plus Erlotinib in Taiwanese Patients with Untreated, Epidermal Growth Factor Receptor-Mutated, Stage IV Non-small Cell Lung Cancer in the RELAY Study

Published date:
06/17/2023
Excerpt:
The aim of this paper was to report efficacy and tolerability findings for the Taiwanese participants of RELAY....Patients were enrolled between 28 January 2016 and 1 February 2018 across 100 investigator sites. Key inclusion criteria for patient enrolment included age at least 18 years (at least 20 years in Taiwan), stage IV NSCLC, EGFR mutation-positive (exon 19 deletion or exon 21 [L858R] substitution)...Median PFS for RAM+ERL/ERL+PBO, respectively, was 22.05 months/13.40 months (unstratified hazard ratio 0.4; 95% confidence interval 0.2-0.9); ORR was 92%/60%; median DoR was 18.2 months/12.7 months.
DOI:
https://doi.org/10.1007/s11523-023-00975-5
Trial ID:
Evidence Level:
Sensitive: B - Late Trials
Title:

Ramucirumab Plus Erlotinib vs. Placebo Plus Erlotinib in Patients With Untreated Metastatic EGFR-Mutated Non-small Cell Lung Cancer: RELAY Japanese Subset

Published date:
04/15/2021
Excerpt:
Median PFS was 19.4 vs. 11.2 months for RAM+ERL vs. PL+ERL treatment (hazard ratio [HR]: 0.610; 95% confidence interval [CI]: 0.431-0.864) in the Japanese intent-to-treat population, 16.6 vs. 12.5 months (HR: 0.701 [0.424-1.159]) in the EGFR exon 19 deletion subgroup, and 19.4 vs. 10.9 months (HR: 0.514 [0.317-0.835]) in the EGFR exon 21 L858R subgroup, respectively....Clinically meaningful efficacy was observed with RAM+ERL vs. PL+ERL in the RELAY Japanese subset, with no new safety concerns.
DOI:
10.1016/j.jtocrr.2021.100171
Trial ID:
Evidence Level:
Sensitive: B - Late Trials
Source:
Title:

Ramucirumab or placebo plus erlotinib in EGFR-mutated, metastatic non-small-cell lung cancer: East Asian subset of RELAY

Published date:
09/20/2020
Excerpt:
Randomized (1:1) patients received oral ERL (150 mg/day) plus intravenous RAM (10 mg/kg) or PL Q2W...PFS benefit was consistent in most subgroups, including by EGFR mutation (Ex19del, Ex21.L858R)...RAM+ERL is a viable treatment option for EGFR-mutated metastatic NSCLC in East Asia.
DOI:
10.1111/cas.14655
Evidence Level:
Sensitive: B - Late Trials
New
Source:
Title:

Ramucirumab plus erlotinib in patients with untreated, EGFR-mutated, advanced non-small-cell lung cancer (RELAY): a randomised, double-blind, placebo-controlled, phase 3 trial

Excerpt:
...patients were aged 18 years or older (20 years or older in Japan and Taiwan) at the time of study entry, had stage IV NSCLC, with an EGFR exon 19 deletion (ex19del) or exon 21 substitution (Leu858Arg) mutation...progression-free survival was significantly longer in the ramucirumab plus erlotinib group (19·4 months [95% CI 15·4–21·6]) than in the placebo plus erlotinib group (12·4 months [11·0–13·5]), with a stratified hazard ratio of 0·59 (95% CI 0·46–0·76; p<0·0001)....Ramucirumab plus erlotinib demonstrated superior progression-free survival compared with placebo plus erlotinib in patients with untreated EGFR-mutated metastatic NSCLC.
DOI:
https://doi.org/10.1016/S1470-2045(19)30634-5
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Go to data
Title:

A Study of Ramucirumab (LY3009806) in Combination With Erlotinib in Previously Untreated Participants With EGFR Mutation-Positive Metastatic NSCLC (RELAY) (RELAY)

Excerpt:
Eligible for first-line treatment with erlotinib based on documented evidence of tumor harboring an activating EGFR mutation [exon 19 deletion or exon 21 (L858R) substitution mutation].
Trial ID:
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

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

Published date:
12/20/2021
Excerpt:
The median PFS of patients who had a ramucirumab or placebo dose adjustment was 20.8 months (95% CI 17.8–22.2) for ramucirumab and 13.9 months (95% CI 12.4–19.3) for placebo...the RELAY trial supports that RAM + ERL...as reflected by the 7-month increase in median PFS for patients in the RAM + ERL arm compared with those in the PBO + ERL arm...RAM + ERL offers a tolerable and effective option for the first-line treatment of EGFR exon 19 deletion or exon 21 (L858R) mutation-positive metastatic NSCLC.
DOI:
10.1007/s40264-021-01127-2
Trial ID:
Evidence Level:
Sensitive: D – Preclinical
Title:

First-line angiogenesis inhibitor plus erlotinib versus erlotinib alone for advanced non-small-cell lung cancer harboring an EGFR mutation

Published date:
07/07/2020
Excerpt:
Four studies evaluated bevacizumab + erlotinib (ARTEMIS, NEJ026, J025667, Stinchcombe et al.), and another evaluated ramucirumab + erlotinib (RELAY). These five eligible studies included 1230 non-squamous NSCLC patients, 654 (53.2%) with exon 19 deletion (ex19del) and 568 (46.8%) with EGFRL858R....The combination (anti-VEGF + erlotinib) was significantly associated with prolonged PFS (hazards ratio [HR] 0.59 [95% confidence interval (CI) 0.51–0.69]; p < 0.00001)....For patients with untreated, advanced, EGFR-mutation-harboring NSCLCs, the anti-VEGF + erlotinib combination, compared to erlotinib alone, was associated with significantly prolonged PFS but mature data for OS are needed to confirm the benefit of this strategy.
DOI:
10.1007/s00432-020-03311-w