Ramucirumab

Ramucirumab is a human monoclonal antibody used in cancer therapy that targets vascular endothelial growth factor receptor-2 (VEGFR-2), also known as KDR. By binding to the extracellular domain of VEGFR-2, ramucirumab blocks the interaction of VEGF ligands with the receptor and inhibits receptor activation and downstream signaling necessary for angiogenesis, thereby slowing tumor blood vessel formation.

Developed by Eli Lilly, ramucirumab is marketed under the brand name Cyramza. It is administered by intravenous infusion and is often used in combination with chemotherapy or as monotherapy, depending on the cancer type and line of therapy.

In the United States, the FDA approved ramucirumab in 2014 for metastatic gastric or gastroesophageal junction adenocarcinoma after progression on prior therapy, both as a single agent and in combination with paclitaxel. Additional approvals followed, including use in metastatic non-small cell lung cancer after progression on platinum therapy (in combination with paclitaxel) and in hepatocellular carcinoma for patients with elevated AFP after sorafenib treatment (as monotherapy).

Adverse effects commonly associated with ramucirumab include hypertension, fatigue, nausea, diarrhea, mucocutaneous toxicity, thromboembolic and hemorrhagic events, infusion-related reactions, wound healing impairment, and proteinuria. As with other anti-angiogenic agents, these risks require monitoring of blood pressure, wound healing, and renal function during treatment.

Research continues into ramucirumab’s activity in additional tumor types and in combination regimens with other targeted therapies or immunotherapies.