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Active Not Recruiting INTERVENTIONAL NCT05633602

Ramucirumab Plus Pembrolizumab vs Usual Care for Treatment of Stage IV or Recurrent Non-Small Cell Lung Cancer Following Immunotherapy, Pragmatica-Lung Study

Pragmatica-Lung: A Prospective Randomized Study of Ramucirumab (LY3009806; NSC 749128) Plus Pembrolizumab (MK-3475; NSC 776864) Versus Standard of Care for Participants Previously Treated With Immunotherapy for Stage IV or Recurrent Non-Small Cell Lung Cancer

Sponsor: Eli Lilly and Company

Updated 14 times since 2022 Last updated: Apr 14, 2026 Started: Mar 14, 2023 Primary completion: Nov 26, 2025 Completion: Mar 15, 2028
This information is for research purposes only and is not medical advice. Consult a healthcare provider before making any medical decision.

A observational or N/A phase clinical study on Recurrent Lung Non-Small Cell Carcinoma and Stage IV Lung Cancer AJCC v8, this trial is ongoing. The trial is conducted by Eli Lilly and Company and has accumulated 14 data snapshots since 2023. Oncology trials at this stage typically focus on safety, tolerability, and early efficacy signals.

Study Description(click to expand)

PRIMARY OBJECTIVE: I. To compare overall survival (OS) in participants previously treated with platinum-based chemotherapy and immunotherapy for stage IV or recurrent non-small cell lung cancer (NSCLC) randomized to pembrolizumab and ramucirumab versus standard of care. SECONDARY OBJECTIVE: I. To summarize reports of serious and unexpected high-grade (\>= grade 3) treatment-related adverse events determined by the treating physician within each treatment arm. OUTLINE: Patients are randomized to 1 of 2 arms. ARM A: Patients receive chemotherapy per standard of care on study. ARM B: Patients receive ramucirumab intravenously (IV) and pembrolizumab IV on study.

PRIMARY OBJECTIVE:

I. To compare overall survival (OS) in participants previously treated with platinum-based chemotherapy and immunotherapy for stage IV or recurrent non-small cell lung cancer (NSCLC) randomized to pembrolizumab and ramucirumab versus standard of care.

SECONDARY OBJECTIVE:

I. To summarize reports of serious and unexpected high-grade (\>= grade 3) treatment-related adverse events determined by the treating physician within each treatment arm.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive chemotherapy per standard of care on study.

ARM B: Patients receive ramucirumab intravenously (IV) and pembrolizumab IV on study.

Status Flow

~Dec 2022 – ~Jan 2023 · 31 days · monthly snapshot~Jan 2023 – ~Feb 2023 · 31 days · monthly snapshot~Feb 2023 – ~Apr 2023 · 59 days · monthly snapshot~Apr 2023 – ~May 2023 · 30 days · monthly snapshot~May 2023 – ~Jun 2023 · 31 days · monthly snapshot~Jun 2023 – ~Oct 2023 · 4 months · monthly snapshot~Oct 2023 – ~Mar 2024 · 5 months · monthly snapshot~Mar 2024 – ~Jul 2024 · 4 months · monthly snapshot~Jul 2024 – ~Sep 2024 · 2 months · monthly snapshot~Sep 2024 – ~Apr 2025 · 7 months · monthly snapshot~Apr 2025 – ~Jun 2025 · 2 months · monthly snapshot~Jun 2025 – ~Sep 2025 · 3 months · monthly snapshot~Sep 2025 – ~Apr 2026 · 8 months · monthly snapshotApr 18, 2026 – present · 2 months · daily API

Change History

14 versions recorded
  1. Apr 18, 2026 — Present [daily]

    Active Not Recruiting

    Phase: PHASE3None

  2. Sep 2025 — Apr 2026 [monthly]

    Active Not Recruiting PHASE3

  3. Jun 2025 — Sep 2025 [monthly]

    Active Not Recruiting PHASE3

    Status: RecruitingActive Not Recruiting

  4. Apr 2025 — Jun 2025 [monthly]

    Recruiting PHASE3

  5. Sep 2024 — Apr 2025 [monthly]

    Recruiting PHASE3

Show 9 earlier versions
  1. Jul 2024 — Sep 2024 [monthly]

    Recruiting PHASE3

  2. Mar 2024 — Jul 2024 [monthly]

    Recruiting PHASE3

  3. Oct 2023 — Mar 2024 [monthly]

    Recruiting PHASE3

  4. Jun 2023 — Oct 2023 [monthly]

    Recruiting PHASE3

  5. May 2023 — Jun 2023 [monthly]

    Recruiting PHASE3

    Status: Not Yet RecruitingRecruiting

  6. Apr 2023 — May 2023 [monthly]

    Not Yet Recruiting PHASE3

  7. Feb 2023 — Apr 2023 [monthly]

    Not Yet Recruiting PHASE3

  8. Jan 2023 — Feb 2023 [monthly]

    Not Yet Recruiting PHASE3

  9. Dec 2022 — Jan 2023 [monthly]

    Not Yet Recruiting PHASE3

    First recorded

Eligibility Summary

This phase III trial compares the effect of the combination of ramucirumab and pembrolizumab versus standard of care chemotherapy for the treatment of non-small cell lung cancer that is stage IV or that has come back after a period of improvement (recurrent). Ramucirumab is a monoclonal antibody that may prevent the growth of new blood vessels that tumors need to grow. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. This trial may help doctors find out if giving ramucirumab with pembrolizumab is more effective at treating patients with stage IV or recurrent non-small cell lung cancer than standard chemotherapy.

Contact Information

Sponsor contact:
  • Eli Lilly and Company
  • Merck Sharp & Dohme LLC
  • National Cancer Institute (NCI)
  • SWOG Cancer Research Network
Data source: ClinicalTrials.gov

For direct contact, visit the study record on ClinicalTrials.gov .