Description

Simple

A chemotherapy agent used for the treatment of certain types of cancer.

Clinical

An antineoplastic agent and direct VEGFR2 (vascular endothelial growth factor receptor 2) antagonist that blocks the binding of natural VEGF ligands, which are secreted by solid tumors to promote angiogenesis and enhance tumor blood supply.

Overview

Ramucirumab is a human monoclonal antibody (IgG1) against vascular endothelial growth factor receptor 2 (VEGFR2), a type II trans-membrane tyrosine kinase receptor expressed on endothelial cells. By binding to VEGFR2, ramucirumab prevents binding of its ligands (VEGF-A, VEGF-C, and VEGF-D), thereby preventing VEGF-stimulated receptor phosphorylation and downstream ligand-induced proliferation, permeability, and migration of human endothelial cells. VEGFR stimulation also mediates downstream signalling required for angiogenesis and is postulated to be heavily involved in cancer progression, making it a highly likely drug target. In contrast to other agents directed against VEGFR-2, ramucirumab binds a specific epitope on the extracellular domain of VEGFR-2, thereby blocking all VEGF ligands from binding to it. Ramucirumab is indicated for us in advanced gastric or gastro-esophageal junction adenocarcinoma as a single agent or in combination with paclitaxel after prior fluoropyrimidine- or platinum-containing chemotherapy.

Pharmacology

Indication

For use in advanced gastric or gastro-esophageal junction adenocarcinoma as a single agent or in combination with paclitaxel after prior fluoropyrimidine- or platinum-containing chemotherapy.

Pharmacodynamic

Information currently not available.

Mechanism of action

Ramucirumab is a human monoclonal antibody (IgG1) against vascular endothelial growth factor receptor 2 (VEGFR2), a type II trans-membrane tyrosine kinase receptor expressed on endothelial cells. By binding to VEGFR2, ramucirumab prevents binding of its ligands (VEGF-A, VEGF-C, and VEGF-D), thereby... Read more

Absorption

Information currently not available.

Protein binding

Information currently not available.

Volume of distribution

5.5 L

Clearance

0.014 L/hour

Half life

15 days

Route of elimination

Information currently not available.

Toxicity

Ramucirumab packaging includes warnings for arterial thromboembolic events, hypertension, infusion-related reactions, gastrointestinal perforation, clinical deterioration in patients with cirrhosis, and reversible posterior leukoencephalopathy syndrome. The most common reactions observed in single-a... Read more

Adverse Effects

Contraindications

Information currently not available.

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Ramucirumab
Type a drug name in the box above to get started
  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
Abciximab
The risk or severity of adverse effects can be increased when Abciximab is combined with Ramucirumab.
Abituzumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Abituzumab.
Abrilumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Abrilumab.
Adalimumab
The risk or severity of adverse effects can be increased when Adalimumab is combined with Ramucirumab.
Adecatumumab
The risk or severity of adverse effects can be increased when Adecatumumab is combined with Ramucirumab.
Aducanumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Aducanumab.
Afelimomab
The risk or severity of adverse effects can be increased when Afelimomab is combined with Ramucirumab.
Alemtuzumab
The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ramucirumab.
Alirocumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Alirocumab.
Amatuximab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Amatuximab.
AMG 108
The risk or severity of adverse effects can be increased when AMG 108 is combined with Ramucirumab.
Anetumab ravtansine
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Anetumab ravtansine.
Anifrolumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Anifrolumab.
Anthrax immune globulin human
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Anthrax immune globulin human.
Antilymphocyte immunoglobulin (horse)
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Antilymphocyte immunoglobulin (horse).
Antithymocyte immunoglobulin (rabbit)
The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Ramucirumab.
Apolizumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Apolizumab.
Apomab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Apomab.
Ascrinvacumab
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Ascrinvacumab.
Asfotase alfa
The risk or severity of adverse effects can be increased when Ramucirumab is combined with Asfotase alfa.
8 References
  1. 1 . Casak SJ, Fashoyin-Aje I, Lemery SJ, Zhang L, Jin R, Li H, Zhao L, Zhao H, Zhang H, Chen H, He K, Dougherty M, Novak R, Kennett S, Khasar S, Helms W, Keegan P, Pazdur R: FDA Approval Summary: Ramucirumab for Gastric Cancer. Clin Cancer Res. 2015 Aug 1;21(15):3372-6. doi: 10.1158/1078-0432.CCR-15-0600. Epub 2015 Jun 5.PubMed: 26048277
  2. 2 . Aprile G, Rijavec E, Fontanella C, Rihawi K, Grossi F: Ramucirumab: preclinical research and clinical development. Onco Targets Ther. 2014 Oct 29;7:1997-2006. doi: 10.2147/OTT.S61132. eCollection 2014.PubMed: 25378934
  3. 3 . Javle M, Smyth EC, Chau I: Ramucirumab: successfully targeting angiogenesis in gastric cancer. Clin Cancer Res. 2014 Dec 1;20(23):5875-81. doi: 10.1158/1078-0432.CCR-14-1071. Epub 2014 Oct 3.PubMed: 25281695
  4. 4 . Aprile G, Bonotto M, Ongaro E, Pozzo C, Giuliani F: Critical appraisal of ramucirumab (IMC-1121B) for cancer treatment: from benchside to clinical use. Drugs. 2013 Dec;73(18):2003-15. doi: 10.1007/s40265-013-0154-8.PubMed: 24277700
  5. 5 . Goodkin R, Zaias B, Michelsen WJ: Arteriovenous malformation and glioma: coexistent or sequential? Case report. J Neurosurg. 1990 May;72(5):798-805.PubMed: 2182794
  6. 6 . Grothey A, Galanis E: Targeting angiogenesis: progress with anti-VEGF treatment with large molecules. Nat Rev Clin Oncol. 2009 Sep;6(9):507-18. doi: 10.1038/nrclinonc.2009.110. Epub 2009 Jul 28.PubMed: 19636328
  7. 7 . Spratlin JL, Cohen RB, Eadens M, Gore L, Camidge DR, Diab S, Leong S, O'Bryant C, Chow LQ, Serkova NJ, Meropol NJ, Lewis NL, Chiorean EG, Fox F, Youssoufian H, Rowinsky EK, Eckhardt SG: Phase I pharmacologic and biologic study of ramucirumab (IMC-1121B), a fully human immunoglobulin G1 monoclonal antibody targeting the vascular endothelial growth factor receptor-2. J Clin Oncol. 2010 Feb 10;28(5):780-7. doi: 10.1200/JCO.2009.23.7537. Epub 2010 Jan 4.PubMed: 20048182
  8. 8 . Lu D, Jimenez X, Zhang H, Bohlen P, Witte L, Zhu Z: Selection of high affinity human neutralizing antibodies to VEGFR2 from a large antibody phage display library for antiangiogenesis therapy. Int J Cancer. 2002 Jan 20;97(3):393-9.PubMed: 11774295