Ramucirumab

Information about Ramucirumab

Ramucirumab is a human monoclonal antibody to the vascular endothelial growth factor (VEGF) receptor 2 and is an antiangiogenesis agent used in the therapy of advanced colorectal, gastric and lung cancers.

Liver safety of Ramucirumab

Ramucirumab has not been linked to serum enzyme elevations during therapy or to instances of idiosyncratic acute liver injury, but has been reported to worsen liver failure in patients with decompensated cirrhosis (Child Class B or C). 

Mechanism of action of Ramucirumab

Ramucirumab (ra" mue sir' ue mab) is a recombinant human monoclonal IgG1 antibody to the vascular endothelial growth factor receptor 2.  Receptors for VEGF are present on endothelial cells, and the engagement of VEGF with these receptors promotes cell proliferation and angiogenesis.  Inhibition of VEGF receptor 2 signaling decreases formation of new blood vessels, which plays an important role in growth and spread of cancer cells.  When used in combination with other antineoplastic agents, ramucirumab has been shown to extend progression-free and overall survival in several forms of advanced cancer. 

FDA approval information for Ramucirumab

Ramucirumab was approved in the United States in 2014 for use in refractory, advanced gastric and metastatic non-small cell lung cancer.  Indications were broadened in 2015 to include metastatic colorectal cancer.  Ramucirumab is available in solution in single use vials of 100 mg in 10 mL or 500 mg in 50 mL (10 mg/mL) under the brand name Cyramza. 

Dosage and administration for Ramucirumab

The typical dose is 8 or 10 mg/kg intravenously at intervals of every 2 or 3 weeks based upon indication the other antineoplastic agents used in combination.  Ramucirumab has significant adverse side effects. 

Side effects of Ramucirumab

Common adverse events include diarrhea, fatigue, anorexia, epistasis, hypertension, neutropenia, and stomatitis.  Uncommon, but potentially severe adverse events include arterial thromboembolic events, severe hypertension, infusion reactions, impaired wound healing, worsening of cirrhosis, thyroid dysfunction, renal dysfunction including proteinuria and nephrotic syndrome, and embryofetal toxicity.

 

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