Ramucirumab (Cyramza)

General information

Class/mechanism: Recombinant human IgG1 monoclonal antibody, VEGFR2 (vascular endothelial growth factor receptor 2) antagonist. Ramucirumab binds VEGFR2 and blocks VEGFR ligands, VEGF-A, VEGF-C, and VEGF-D, which inhibits angiogenesis.
Route: IV
Extravasation: no information

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Bladder cancer
• Colon cancer
• Gastric cancer
• Hepatocellular carcinoma
• Non-small cell lung cancer

Patient drug information

• Ramucirumab (Cyramza) patient drug information (Chemocare)
• Ramucirumab (Cyramza) package insert
• Ramucirumab (Cyramza) patient drug information (UpToDate)

History of changes in FDA indication

Colorectal cancer

• 4/24/2015: Approved 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. (New disease approval)

Gastric cancer

• 4/21/2014: Initial approval for the treatment of patients with advanced or metastatic, gastric or gastroesophageal junction (GEJ) adenocarcinoma with disease progression on or after prior treatment with fluoropyrimidine- or platinum- containing chemotherapy.
• 11/5/2014: Approval and indication expanded for use in combination with paclitaxel for the treatment of patients with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma. (Requirement for prior lines of treatment removed)

Hepatocellular carcinoma

• 5/10/2019: Approved as a single agent for hepatocellular carcinoma (HCC) in patients who have an alpha fetoprotein (AFP) of at least 400 ng/mL and have been previously treated with sorafenib. (New disease approval)

Non-small cell lung cancer

• 12/12/2014: Approved for use in combination with docetaxel for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) with disease progression on or after platinum-based chemotherapy. (New disease approval)

Also known as

• Code names: IMC-1121B, LY3009806
• Brand name: Cyramza