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Anti-angiogenic agent ramucirumab: meaningful or marginal?

Abstract
Ramucirumab (IMC-1121B) targets VEGFR-2. Ramucirumab is being investigated in many malignancies including gastric cancer. The Phase III trial in patients with advanced breast cancer failed to improve the primary end point The REGARD trial, a Phase III study, in patients with advanced gastric cancer in the second line setting, had a marginal improvement in overall survival but did not achieve the expected hazard ratio target (of 0.69) and the median duration of therapy with ramucirumab was meager 8 weeks (only 2 weeks longer than the placebo's). Other notable agents in the second line setting are docetaxel and irinotecan. Preliminary results of the RAINBOW trial suggest that ramucirumab may be providing more than marginal advantage. In this review, we briefly summarize the process of angiogenesis and address the emerging cost-benefit issues that surround all newly developed agents including ramucirumab.
AuthorsRoopma Wadhwa, Elena Elimova, Hironori Shiozaki, Kazuki Sudo, Mariela A Blum, Jeannelyn S Estrella, Qiongrong Chen, Shumei Song, Jaffer A Ajani
JournalExpert review of anticancer therapy (Expert Rev Anticancer Ther) Vol. 14 Issue 4 Pg. 367-79 (Apr 2014) ISSN: 1744-8328 [Electronic] England
PMID24605771 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • ramucirumab
  • Vascular Endothelial Growth Factor Receptor-2
Topics
  • Angiogenesis Inhibitors (adverse effects, economics, therapeutic use)
  • Antibodies, Monoclonal (adverse effects, chemistry, economics, therapeutic use)
  • Antibodies, Monoclonal, Humanized
  • Breast Neoplasms (blood supply)
  • Clinical Trials as Topic
  • Cost-Benefit Analysis
  • Drug Approval
  • Drug Resistance, Neoplasm
  • Humans
  • Neovascularization, Pathologic (drug therapy)
  • Stomach Neoplasms (blood supply)
  • Vascular Endothelial Growth Factor Receptor-2 (antagonists & inhibitors)

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