Ramucirumab: hitting another target in gastric cancer

Abstract:

Gastric cancer remains a lethal disease worldwide. Despite a recent increase in available systemic therapeutics, the prognosis of patients with advanced disease remains poor. A number of targeted therapies have been evaluated in gastric cancer, albeit with mixed results. Trastuzumab – the monoclonal antibody blocking HER2 – has contributed to improved survival for a minority of gastric cancer patients. Ramucirumab – a VEGF2 inhibitor – blocks the proliferation and migration of endothelial cells. The US Food and Drug Administration has recently approved ramucirumab (Cyramza) to treat patients with advanced or metastatic gastric cancer in the second-line setting following progression on fluoropyrimidine- or platinum-containing therapy. This approval was granted on the basis of the REGARD trial that demonstrated that patients treated with ramucirumab experienced a median overall survival of 5.2 months compared with 3.8 months in patients receiving placebo. Results from the RAINBOW randomized Phase III clinical trial have also shown improvements in overall survival for ramucirumab plus paclitaxel versus paclitaxel alone in patients previously treated for locally advanced or metastatic gastric cancer. In both studies, the most common adverse events reported were hypertension, diarrhea, and fatigue. Because of the encouraging advancement in novel targeted therapies, the future is looking brighter for patients with advanced gastric cancer. While this research is promising, further evaluation and identification of targets or population subsets that can be identified prospectively will likely help predict who will benefit most from these therapies.

Keywords::

• metastatic gastric cancer
• ramucirumab
• targeted therapies
• angiogenesis
• Cyramza

Disclosure

The authors report no conflicts of interest in this work.