Drug updated on 4/17/2024
| Dosage Form | Injection (intravenous; 100 mg/10 mL [10 mg/mL], 500 mg/50 mL [10 mg/mL]) |
| Drug Class | Human vascular endothelial growth factor receptor 2 antagonists |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated as a single agent or in combination with paclitaxel, for treatment of advanced or metastatic gastric or gastro-esophageal junction adenocarcinoma with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy.
- Indicated in combination with erlotinib, for first-line treatment of metastatic non-small cell lung cancer with epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) mutations.
- Indicated in combination with docetaxel, for treatment of metastatic non-small cell lung cancer with disease progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving CYRAMZA.
- Indicated in combination with FOLFIRI, for the treatment of metastatic colorectal cancer with disease progression on or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine.
- Indicated as a single agent, for the treatment of hepatocellular carcinoma in patients who have an alpha fetoprotein of ≥400 ng/mL and have been treated with sorafenib.
Summary
- Ramucirumab (Cyramza) is indicated for the treatment of various cancers, including non-small cell lung cancer, gastric or gastro-esophageal junction adenocarcinoma, hepatocellular carcinoma, and metastatic colorectal cancer. It can be used as a single agent or in combination with other drugs such as paclitaxel, erlotinib, and docetaxel.
- The information was derived from 20 systematic reviews/meta-analyses related to ramucirumab's use across different indications.
- In comparison to EGFR-TKIs and chemotherapy for non-small cell lung cancer patients with specific genetic mutations (EGFR mutations), ramucirumab combined with docetaxel showed improved overall survival rates after prior therapy failure.
- For gastric/gastro-esophageal junction adenocarcinoma patients, ramucirumab plus chemotherapy demonstrated superior outcomes in terms of overall survival compared to chemotherapy alone. This indicates that it offers a valuable option in both the first-line and later settings.
- When treating hepatocellular carcinoma, particularly for patients with elevated alpha-fetoprotein levels post-sorafenib treatment, ramucirumab has shown effectiveness in improving overall survival, positioning it as a viable second-line therapy option.
- In cases of metastatic colorectal cancer progressing after first-line therapy, ramucirumab, combined with FOLFIRI, improved both progression-free survival rates and overall survival rates, emphasizing its contribution towards treatment escalation strategies.
- Across all these indications mentioned above, the safety profile remained consistent, aligning closely with adult experiences without any new safety signals emerging from comparative analyses, even within pediatric populations or specific patient subsets which were part of this study review process.
- The effectiveness varied across different types of cancers, highlighting the importance of patient selection based on factors like molecular subgroups, etc., thus underscoring the necessity of personalized therapeutic strategies considering disease type and progression patterns along with prior treatment history.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Cyramza (ramucirumab) prescribing information. | 2022 | FDA |