title: The safety and efficacy of ramucirumab for the treatment of metastatic colorectal cancer.
abstract: BACKGROUND
  Ramucirumab (IMC-1121B, LY3009806) is a fully humanized monoclonal antibody that targets the extracellular domain of vascular endothelial growth factor receptor 2 (VEGFR2), the principal mediator of VEGF-A downstream effects in cancer angiogenesis. Ramucirumab has been recently approved for use in combination with FOLFIRI for the treatment of patients with metastatic colorectal cancer (mCRC) whose disease has progressed on a first line bevacizumab-, oxaliplatin- and fluoropyrimidine-containing regimen. This approval was based on the results of the RAISE phase III placebo-controlled trial. This study demonstrated that the addition of ramucirumab to irinotecan-based chemotherapy significantly improved progression-free and overall survival of patients with mCRC, with manageable toxicity.
  
  
  METHODS
  The aim of this drug profile is to briefly summarize the pharmacology, clinical efficacy, safety and tolerability of ramucirumab in the context of metastatic colorectal cancer, and to provide some perspective regarding the role of the drug in clinical practice. Expert commentary: Pending issues that shall be addressed in the upcoming years include the optimization of ramucirumab dosing schedule, assessment of its role with other chemotherapy regimens or in other treatment settings, comparative evaluation of this agent with other antiangiogenics, and identification of predictive biomarkers to improve the therapeutic index and cost-effectiveness of this drug.
authors.affiliation: a Medical Oncology Division , Hospital Universitario 12 de Octubre , Madrid , Spain.
authors.forename: Asuncion
authors.initials: A
authors.lastname: Diaz-Serrano
authors.affiliation: a Medical Oncology Division , Hospital Universitario 12 de Octubre , Madrid , Spain.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Riesco-Martinez
authors.affiliation: a Medical Oncology Division , Hospital Universitario 12 de Octubre , Madrid , Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Garcia-Carbonero
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D000077146:Irinotecan; D009362:Neoplasm Metastasis; D015996:Survival Rate; D016896:Treatment Outcome; D000096662:Ramucirumab
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; D002166:Camptothecin; D000077146:Irinotecan; D000096662:Ramucirumab
keywords: Ramucirumab; VEGFR2; advanced disease; angiogenesis; chemotherapy; colorectal cancer; monoclonal antibody; vascular endothelial growth factor