Ramucirumab for gastric cancer

Abstract

In recent years, various molecular target agents have been investigated for gastric cancer. VEGF is one of the most potent angiogenic factors and is a signaling molecule secreted by many solid tumors. High VEGF expression is one of the characteristic features of gastric carcinomas, thus targeting VEGF is considered a promising strategy for gastric cancer. Ramucirumab, an anti-VEGF receptor antibody, has proven to be effective for previously treated advanced gastric cancer. Details of ramucirumab, including two pivotal Phase III studies, will be discussed in this review. Ramucirumab, with or without chemotherapy, improved survival in gastric cancer after previous systemic chemotherapy, thus becoming the standard of care for this patient population. Optimal timing of ramucirumab use and adequate biomarkers for patient selection as well as mechanism of resistance should be explored in future research.

Keywords:

• anti-VEGFR monoclonal antibodies
• gastric cancer
• ramucirumab
• vascular endothelial growth factor receptor

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Ramucirumab, an anti-VEGF receptor antibody is proven to be effective for previously treated advanced gastric cancer.

• The addition of ramucirumab to best supportive care was associated with significantly improved overall survival (5.2 vs 3.8 months) of patients after disease progression on first-line platinum or fluoropyrimidine-containing combination therapy in REGARD study.

• Ramucirumab plus paclitaxel chemotherapy significantly increased overall survival compared with paclitaxel alone (9.63 vs 7.36 months) of patients after first-line platinum- and fluoropyrimidine-based chemotherapy. Progression-free survival and objective response was also improved.

• Major side effects of ramucirumab include hypertension or proteinuria as monotherapy and increased frequency of neutropenia was observed in RAINBOW study.

Notes