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Ramucirumab: Successfully Targeting Angiogenesis in Gastric Cancer #MMPMID25281695
Javle M; Smyth EC; Chau I
Clin Cancer Res 2014[Dec]; 20 (23): 5875-81 PMID25281695show ga
Gastric cancer is the fourth most common cancer globally and represents the second most common cause of cancer mortality. Early detection, aggressive surgical resection and postoperative adjuvant therapy has led to survival improvement for early stage gastric cancer, particularly in Asian countries. Unfortunately, advanced gastric cancer continues to pose a formidable challenge with few gains being reported recently. Trastuzumab was the first targeted agent to be approved for the treatment of advanced gastric cancer in 2010. The failure of the AVAGAST trial was a setback for anti-angiogenic therapy for this disease. Ramucirumab is a monoclonal antibody that binds to VEGF-R2 and prevents its activation. The recent REGARD trial was a randomized phase III trial of ramucirumab vs. placebo for patients with advanced, pre-treated gastric cancer that met its primary endpoint of increased overall survival. The toxicity of ramucirumab was modest in this setting, with an increased risk of grade 3 or higher hypertension (8% vs. 3%, with ramucirumab and placebo, respectively). The subsequent RAINBOW trial of paclitaxel plus ramucirumab vs. paclitaxel plus placebo for advanced pretreated gastric cancer confirmed the survival advantage of this antiangiogenic agent in gastric cancer. Ramucirumab is the first FDA approved therapy for advanced gastric cancer after prior chemotherapy.
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Clin+Cancer+Res 2014 ; 20 (23): 5875-81
