title: Ramucirumab: A vascular endothelial growth factor receptor-2 inhibitor with activity in several malignancies.
abstract: OBJECTIVE
  The pharmacology, pharmacokinetics, safety, dosage and administration, current and potential roles in therapy, and cost considerations of ramucirumab are reviewed.
  
  
  CONCLUSIONS
  Ramucirumab is a recombinant monoclonal antibody that selectively inhibits vascular endothelial growth factor receptor-2. Ramucirumab has been approved for the treatment of gastric cancer, non-small-cell lung cancer (NSCLC), and metastatic colorectal cancer. Ramucirumab displays similar pharmacokinetics in patients with gastric cancer, NSCLC, and metastatic colorectal cancer. The most common adverse effects of any grade with ramucirumab monotherapy included fatigue, decreased appetite, abdominal pain, hypertension, anemia, hemorrhage, and diarrhea. For ramucirumab monotherapy in patients with gastric cancer, ramucirumab 8 mg/kg should be administered by i.v. infusion every two weeks. For combination therapy, ramucirumab should be administered at the same dose with weekly paclitaxel 80 mg/m(2) i.v. on days 1, 8, and 15 every 28 days. When treating NSCLC, the recommended ramucirumab dose is 10 mg/kg i.v. with docetaxel 75 mg/m(2) i.v. on day 1 every 21 days. For combination therapy with FOLFIRI (fluorouracil, leucovorin, and irinotecan) for metastatic colorectal cancer, ramucirumab 8 mg/kg should be administered by i.v. infusion every two weeks. The average wholesale prices of ramucirumab are $1224 and $6120 for the 100- and 500-mg single-dose vials, respectively.
  
  
  CONCLUSIONS
  Ramucirumab has demonstrated benefit in a variety of cancers, supporting the role of antiangiogenic agents in the management of malignancies. However, the clinical benefit in certain malignancies may be offset by the high cost of ramucirumab and the duration of treatment.
authors.affiliation: University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Grabowski
authors.affiliation: University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO. ashley.glode@ucdenver.edu.
authors.forename: Ashley
authors.initials: A
authors.lastname: Glode
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000493:pharmacokinetics / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000037:antagonists & inhibitors*; D000096662:Ramucirumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D040301:Vascular Endothelial Growth Factor Receptor-2; D000096662:Ramucirumab; C000588866:KDR protein, human