Ramucirumab: A New Agent for Advanced or Metastatic Gastric Junction Adenocarcinoma

Ramucirumab (Cyramza®), approved April 21, 2014, is a vascular endothelial growth factor receptor 2 (VEGFR2) antagonist with a U.S. Food and Drug Administration (FDA) indication for the treatment of advanced or metastatic gastric/gastroesophageal junction adenocarcinoma. Gastric cancer is a prevalent cancer in the United States with a poor prognosis. The phase 3 trial, REGARD, shows that ramucirumab, when used within four months after the last dose of first-line chemotherapy or six months after the last dose of adjuvant chemotherapy, increases overall survival. Also, ramucirumab has been included in combination therapy, such as in the RAINBOW trial, which demonstrated its effectiveness in combination with paclitaxel as a second-line treatment option. Notable adverse reactions to ramucirumab are severe hypertension and injection site reactions. Because it is a newer anticancer agent, ramucirumab’s full potential may not yet be recognized. Possible future uses of ramucirumab may include the treatment of other forms of cancer or utilization as a first-line agent.