# Lung-MAP S1800A: ramucirumab plus pembrolizumab

Source: https://onco.cc/trials/lung-map-s1800a/  
OnCo record `lung-map-s1800a` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In people whose lung cancer had already got past chemotherapy and immunotherapy, the Lung-MAP sub-study S1800A found that a blood-vessel blocker (ramucirumab) plus pembrolizumab helped them live longer than more chemotherapy did. A larger, simpler trial was launched to confirm it.

## Summary

S1800A was the first Lung-MAP sub-study designed for patients whose non-small-cell lung cancer had progressed after immune checkpoint therapy, a group with no good standard. It randomised 166 patients to ramucirumab with pembrolizumab or to standard of care (docetaxel with or without ramucirumab, gemcitabine or pemetrexed), with overall survival as the primary endpoint of a phase 2 designed to detect a large signal.

Karen Reckamp and colleagues reported in the Journal of Clinical Oncology in 2022 that median overall survival was 14.5 months with the combination against 11.6 months with standard care, a hazard ratio of 0.69, with fewer severe side effects. Response rates were similar in both arms, so the benefit appeared to come from disease control rather than shrinkage, and progression-free survival was not significantly different.

Because a phase 2 survival signal in 166 patients is not proof, SWOG and the NCI opened Pragmatica-Lung (S2302), a deliberately simple phase 3 with minimal eligibility rules and data collection, to confirm the result in a population close to routine practice. S1800A also became the model for Lung-MAP's later immunotherapy-combination sub-studies in patients who have already had checkpoint blockade.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Also known as: S1800A; SWOG S1800A
- Registry id: NCT03971474
- Phase: 2
- Setting: Stage 4 non-small-cell lung cancer that has progressed after both platinum chemotherapy and immunotherapy: ramucirumab plus pembrolizumab against investigator's choice of standard chemotherapy
- Sponsor: SWOG Cancer Research Network and the National Cancer Institute
- Result: Median overall survival 14.5 months with ramucirumab plus pembrolizumab versus 11.6 months with standard of care (hazard ratio 0.69); confirmation sought in the phase 3 Pragmatica-Lung.
- Outcomes: Overall survival: Ramucirumab + pembrolizumab 14.5 months vs Standard of care 11.6 months, HR 0.69

## Sources

- ClinicalTrials.gov NCT03971474: https://clinicaltrials.gov/study/NCT03971474
- Reckamp et al., Journal of Clinical Oncology 2022: phase II randomized study of ramucirumab and pembrolizumab versus standard of care in advanced NSCLC previously treated with immunotherapy (Lung-MAP S1800A): https://doi.org/10.1200/JCO.22.00912

## Connected records

- cancers: [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/)
- drugs: [Docetaxel](https://onco.cc/drugs/docetaxel/), [Gemcitabine](https://onco.cc/drugs/gemcitabine/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [Pemetrexed](https://onco.cc/drugs/pemetrexed/), [Ramucirumab](https://onco.cc/drugs/ramucirumab/)
- institutions: [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/), [SWOG Cancer Research Network](https://onco.cc/institutions/swog/)
- terms: [Basket, umbrella, and platform trials](https://onco.cc/terms/basket-umbrella-platform/), [Master protocol (platform, basket and umbrella trials)](https://onco.cc/terms/master-protocol/)
- trials: [Lung-MAP (SWOG S1400 and S1900)](https://onco.cc/trials/lung-map/)

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