Clinical utility of ramucirumab in non-small-cell lung cancer

Dipesh UpretyDepartment of Medical Oncology, Mayo Clinic, Rochester, MN, USAAbstract: Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC) accounts for about 85% of all lung cancer cases and approximately 70% of patients with NSCLC have locally a...

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Autor principal:	Uprety D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Ramucirumab VEGFR-2 Non small cell lung cancer NSCLC Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/4b26539441874b838be363447f27f263
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spelling	oai:doaj.org-article:4b26539441874b838be363447f27f2632021-12-02T04:04:02ZClinical utility of ramucirumab in non-small-cell lung cancer1177-5491https://doaj.org/article/4b26539441874b838be363447f27f2632019-07-01T00:00:00Zhttps://www.dovepress.com/clinical-utility-of-ramucirumab-in-non-small-cell-lung-cancer-peer-reviewed-article-BTThttps://doaj.org/toc/1177-5491Dipesh UpretyDepartment of Medical Oncology, Mayo Clinic, Rochester, MN, USAAbstract: Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC) accounts for about 85% of all lung cancer cases and approximately 70% of patients with NSCLC have locally advanced or metastatic disease at presentation. In NSCLC patients with advanced or metastatic disease, second line treatment with chemotherapy is associated with a poor response rate. In this article, we have reviewed the role of ramucirumab in patients with NSCLC. Ramucirumab is not current standard of care in the first line setting in the treatment of advanced or metastatic NSCLC, based on phase II data which did not show any progression-free survival (PFS) and overall survival (OS) benefit when ramucirumab was compared with non-ramucirumab arm. The REVEL study was a phase III, placebo-controlled trial which included patients with stage IV NSCLC who had progressed during or after platinum-based chemotherapy, with or without bevacizumab. Median OS was 9.1 months vs 10.5 months (HR 0.86, 95% CI 0.75–0.98) in the placebo and ramucirumab group respectively. Seventy-nine percent of patients in ramucirumab arm and 71% of patients in non-ramucirumab arm had grade ≥3 treatment-related adverse events. The addition of ramucirumab to docetaxel can be considered in younger patients with good performance status as a second line treatment option. Additionally, combined blockage of the VEGFR and EGFR pathway has been utilized to overcome resistance to EGFR therapy. The RELAY trial was a phase III, placebo-controlled trial which included patients with sensitizing EGFR mutation positive stage IV NSCLC. Patients were randomized to either ramucirumab plus erlotinib or erlotinib. The trial showed that the combination therapy showed superior PFS benefit.Keywords: ramucirumab, non-small-cell lung cancer, NSCLCUprety DDove Medical PressarticleRamucirumab VEGFR-2 Non small cell lung cancer NSCLCMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol Volume 13, Pp 133-137 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ramucirumab VEGFR-2 Non small cell lung cancer NSCLC Medicine (General) R5-920
spellingShingle	Ramucirumab VEGFR-2 Non small cell lung cancer NSCLC Medicine (General) R5-920 Uprety D Clinical utility of ramucirumab in non-small-cell lung cancer
description	Dipesh UpretyDepartment of Medical Oncology, Mayo Clinic, Rochester, MN, USAAbstract: Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC) accounts for about 85% of all lung cancer cases and approximately 70% of patients with NSCLC have locally advanced or metastatic disease at presentation. In NSCLC patients with advanced or metastatic disease, second line treatment with chemotherapy is associated with a poor response rate. In this article, we have reviewed the role of ramucirumab in patients with NSCLC. Ramucirumab is not current standard of care in the first line setting in the treatment of advanced or metastatic NSCLC, based on phase II data which did not show any progression-free survival (PFS) and overall survival (OS) benefit when ramucirumab was compared with non-ramucirumab arm. The REVEL study was a phase III, placebo-controlled trial which included patients with stage IV NSCLC who had progressed during or after platinum-based chemotherapy, with or without bevacizumab. Median OS was 9.1 months vs 10.5 months (HR 0.86, 95% CI 0.75–0.98) in the placebo and ramucirumab group respectively. Seventy-nine percent of patients in ramucirumab arm and 71% of patients in non-ramucirumab arm had grade ≥3 treatment-related adverse events. The addition of ramucirumab to docetaxel can be considered in younger patients with good performance status as a second line treatment option. Additionally, combined blockage of the VEGFR and EGFR pathway has been utilized to overcome resistance to EGFR therapy. The RELAY trial was a phase III, placebo-controlled trial which included patients with sensitizing EGFR mutation positive stage IV NSCLC. Patients were randomized to either ramucirumab plus erlotinib or erlotinib. The trial showed that the combination therapy showed superior PFS benefit.Keywords: ramucirumab, non-small-cell lung cancer, NSCLC
format	article
author	Uprety D
author_facet	Uprety D
author_sort	Uprety D
title	Clinical utility of ramucirumab in non-small-cell lung cancer
title_short	Clinical utility of ramucirumab in non-small-cell lung cancer
title_full	Clinical utility of ramucirumab in non-small-cell lung cancer
title_fullStr	Clinical utility of ramucirumab in non-small-cell lung cancer
title_full_unstemmed	Clinical utility of ramucirumab in non-small-cell lung cancer
title_sort	clinical utility of ramucirumab in non-small-cell lung cancer
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/4b26539441874b838be363447f27f263
work_keys_str_mv	AT upretyd clinicalutilityoframucirumabinnonsmallcelllungcancer
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Clinical utility of ramucirumab in non-small-cell lung cancer

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