What is Ramucirumab
Ramucirumab is a fully human monoclonal antibody that binds with high affinity to the extracellular domain of vascular endothelial growth factor receptor 2 (VEGFR2; kinase insert domain-containing receptor; KDR), preventing the binding of VEGF-A, VEGF-C, and VEGF-D.
The mechanism of binding to VEGFR2 rather than VEGF may lead to less resistance since endothelial cells are genetically stable.
Ramucirumab is indicated as monotherapy for the treatment of advanced or metastatic gastric or gastro-esophageal junction (GEJ) cancer as well as previously treated hepatocellular cancer in patients with an alpha-fetoprotein of 400 ng/mL or more.
It is also indicated in combination with paclitaxel for advanced or metastatic gastric/GEJ cancer, in combination with docetaxel for metastatic non-small cell lung cancer (NSCLC) after progression on platinum-based therapy, and in combination with FOLFIRI for metastatic colorectal cancer in patients previously treated with bevacizumab, oxaliplatin, and a fluoropyrimidine.
Brand Name
Cyramza
Indications
- colorectal cancer
- gastric cancer
- hepatocellular cancer
- non-small cell lung cancer (NSCLC)
For the treatment of gastric cancer or gastro-esophageal junction adenocarcinoma
for the treatment of advanced or metastatic gastric or gastro-esophageal junction adenocarcinoma with disease progression on or after fluoropyrimidine- or platinum-containing chemotherapy, as monotherapy
Side Effects
- abdominal pain
- abdominal pain
- anorexia
- anorexia
- antibody formation
- ascites
- ascites
- asthenia
- asthenia
- back pain
- back pain
- bleeding
- bleeding
- bronchospasm
- cardiac arrest
- chest pain (unspecified)
- chills
- diarrhea
- diarrhea
- dysphonia
- dyspnea
- encephalopathy
- epistaxis
- epistaxis
- fatigue
- fatigue
- fever
- flushing
- GI bleeding
- GI bleeding
- GI obstruction
- GI perforation
- headache
- hepatic encephalopathy
- hepatic encephalopathy
- hypertension
- hypertension
- hypoalbuminemia
- hypoalbuminemia
- hypocalcemia
- hypocalcemia
- hyponatremia
- hyponatremia
- hypotension
- hypothyroidism
- hypoxia
- impaired wound healing
- infection
- infusion-related reactions
- infusion-related reactions
- insomnia
- lacrimation
- lacrimation
- leukoencephalopathy
- myocardial infarction
- nausea
- nephrotic syndrome
- neutropenia
- neutropenia
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- paresthesias
- peripheral edema
- peripheral edema
- proteinuria
- proteinuria
- rash
- stomatitis
- stomatitis
- stroke
- supraventricular tachycardia (SVT)
- thrombocytopenia
- thrombocytopenia
- thrombosis
- thrombotic microangiopathy
- tremor
- vomiting
- wheezing
Monitoring Parameters
- blood pressure
- pregnancy testing
- thyroid function tests (TFTs)
- urinalysis
Contraindications
- anticoagulant therapy
- biliary cirrhosis
- bleeding
- breast-feeding
- cardiac arrest
- contraception requirements
- encephalopathy
- GI bleeding
- GI perforation
- hepatic disease
- human anti-human antibody (HAHA)
- hypertension
- hypothyroidism
- impaired wound healing
- infertility
- infusion-related reactions
- myocardial infarction
- pregnancy
- pregnancy testing
- proteinuria
- renal disease
- reproductive risk
- stroke
- surgery
- thyroid disease
Interactions
- Clozapine
- Palifermin
- Penicillamine
- Tuberculin Purified Protein Derivative, PPD
