Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity

Manuel Cobo,1 Vanesa Gutiérrez,1 Rosa Villatoro,2 Jose Manuel Trigo,1 Inmaculada Ramos,1 Omar López,1 María Ruiz,1 Ana Godoy,1 Irene López,1 Macarena Arroyo3 1Medical Oncology Department, Hospital Universitario Málaga Regional y Virgen de la Vic...

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Autores principales: Cobo M, Gutiérrez V, Villatoro R, Trigo JM, Ramos I, López O, Ruiz M, Godoy A, López I, Arroyo M
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Publicado: Dove Medical Press 2017
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spelling oai:doaj.org-article:9ce6e473f41f4ac5838784a2d4df92bc2021-12-02T02:41:05ZSpotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity1179-2728https://doaj.org/article/9ce6e473f41f4ac5838784a2d4df92bc2017-07-01T00:00:00Zhttps://www.dovepress.com/spotlight-on-ramucirumab-in-the-treatment-of-nonsmall-cell-lung-cancer-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Manuel Cobo,1 Vanesa Gutiérrez,1 Rosa Villatoro,2 Jose Manuel Trigo,1 Inmaculada Ramos,1 Omar López,1 María Ruiz,1 Ana Godoy,1 Irene López,1 Macarena Arroyo3 1Medical Oncology Department, Hospital Universitario Málaga Regional y Virgen de la Victoria, IBIMA, 2Medical Oncology Department, Hospital Costa del Sol, Marbella, IBIMA, 3Pneumology Department, Hospital Universitario Málaga Regional, IBIMA, Málaga, Spain Abstract: The vascular endothelial growth factor (VEGF) and receptor is a therapeutic target because of the importance of this pathway in carcinogenesis. This pathway regulates and promotes angiogenesis as well as increases endothelial cell proliferation, permeability, and cancer survival. Ramucirumab is a new fully human monoclonal antibody that targets the VEGF receptor-2, an important key receptor implicated in angiogenesis. Ramucirumab has been approved for the treatment of second-line advanced or metastatic non-small cell lung cancer (NSCLC) in combination with the chemotherapy agent docetaxel. This was based on the result of the randomized trial REVEL of 1,253 patients with metastatic NSCLC previously treated with a platinum-based combination therapy. The authors observed a significant improvement in overall survival (OS) with an acceptable toxicities profile. In this study, patients were randomized to receive ramucirumab plus docetaxel or placebo with docetaxel. The combination of docetaxel and ramucirumab showed an improved OS (hazard ratio [HR]: 0.86; 95% CI: 0.75, 0.98). Median OS was 10.5 months in the ramucirumab arm versus 9.1 months in the placebo arm. Regarding side effects, the toxicity described on the ramucirumab arm were principally diarrhea, fatigue, and neutropenia. The most common (5%) adverse reactions of grade 3 and 4 in the ramucirumab arm were fatigue, neutropenia, febrile neutropenia, leukopenia, and hypertension. Adding ramucirumab to docetaxel improves QoL of patients, and does not impair symptoms or functioning. There are currently several trials in progress evaluating the effects of ramucirumab in combination with other drugs in patients with advanced NSCLC. Keywords: ramucirumab, NSCLC, antiangiogenesis, VEGF-targeted therapy, pretreatedCobo MGutiérrez VVillatoro RTrigo JMRamos ILópez ORuiz MGodoy ALópez IArroyo MDove Medical PressarticleRamucirumabNSCLCantiangiogenesisVEGF-targeted therapysecond line therapy.Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 8, Pp 57-66 (2017)
institution DOAJ
collection DOAJ
language EN
topic Ramucirumab
NSCLC
antiangiogenesis
VEGF-targeted therapy
second line therapy.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle Ramucirumab
NSCLC
antiangiogenesis
VEGF-targeted therapy
second line therapy.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Cobo M
Gutiérrez V
Villatoro R
Trigo JM
Ramos I
López O
Ruiz M
Godoy A
López I
Arroyo M
Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
description Manuel Cobo,1 Vanesa Gutiérrez,1 Rosa Villatoro,2 Jose Manuel Trigo,1 Inmaculada Ramos,1 Omar López,1 María Ruiz,1 Ana Godoy,1 Irene López,1 Macarena Arroyo3 1Medical Oncology Department, Hospital Universitario Málaga Regional y Virgen de la Victoria, IBIMA, 2Medical Oncology Department, Hospital Costa del Sol, Marbella, IBIMA, 3Pneumology Department, Hospital Universitario Málaga Regional, IBIMA, Málaga, Spain Abstract: The vascular endothelial growth factor (VEGF) and receptor is a therapeutic target because of the importance of this pathway in carcinogenesis. This pathway regulates and promotes angiogenesis as well as increases endothelial cell proliferation, permeability, and cancer survival. Ramucirumab is a new fully human monoclonal antibody that targets the VEGF receptor-2, an important key receptor implicated in angiogenesis. Ramucirumab has been approved for the treatment of second-line advanced or metastatic non-small cell lung cancer (NSCLC) in combination with the chemotherapy agent docetaxel. This was based on the result of the randomized trial REVEL of 1,253 patients with metastatic NSCLC previously treated with a platinum-based combination therapy. The authors observed a significant improvement in overall survival (OS) with an acceptable toxicities profile. In this study, patients were randomized to receive ramucirumab plus docetaxel or placebo with docetaxel. The combination of docetaxel and ramucirumab showed an improved OS (hazard ratio [HR]: 0.86; 95% CI: 0.75, 0.98). Median OS was 10.5 months in the ramucirumab arm versus 9.1 months in the placebo arm. Regarding side effects, the toxicity described on the ramucirumab arm were principally diarrhea, fatigue, and neutropenia. The most common (5%) adverse reactions of grade 3 and 4 in the ramucirumab arm were fatigue, neutropenia, febrile neutropenia, leukopenia, and hypertension. Adding ramucirumab to docetaxel improves QoL of patients, and does not impair symptoms or functioning. There are currently several trials in progress evaluating the effects of ramucirumab in combination with other drugs in patients with advanced NSCLC. Keywords: ramucirumab, NSCLC, antiangiogenesis, VEGF-targeted therapy, pretreated
format article
author Cobo M
Gutiérrez V
Villatoro R
Trigo JM
Ramos I
López O
Ruiz M
Godoy A
López I
Arroyo M
author_facet Cobo M
Gutiérrez V
Villatoro R
Trigo JM
Ramos I
López O
Ruiz M
Godoy A
López I
Arroyo M
author_sort Cobo M
title Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
title_short Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
title_full Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
title_fullStr Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
title_full_unstemmed Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
title_sort spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/9ce6e473f41f4ac5838784a2d4df92bc
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