Cyramza (ramucirumab)

Patients received RAM (10 mg/kg every 2 wk) plus GEF (250 mg once daily) until disease progression (period 1); patients with disease progression who acquired a T790M mutation received RAM plus osimertinib (80 mg once daily) (period 2). Treatment-emergent T790M rate post progression was 81.3%. RELAY+ revealed a favorable benefit-risk profile for RAM plus GEF in East Asian patients with untreated EGFR-mutated metastatic NSCLC, supporting RAM plus GEF as an alternative first-line treatment option, particularly in those with an L858R mutation.

P3, N=572, Recruiting, AstraZeneca | Trial completion date: Apr 2027 --> Sep 2026 | Trial primary completion date: Oct 2026 --> May 2026

Paired peripheral blood mass cytometry revealed lower proportions of myeloid-derived suppressor cells in responders. Together these data highlight on-treatment remodeling under the therapeutic pressure of dual VEGF and PD-1 blockade, and suggest features associated with the durable benefit seen in a subset of patients.

In patients receiving immune checkpoint inhibitors, consider myocarditis in atypical Takotsubo presentations; biopsy and early steroids improve outcomes.

This review examines the mechanisms, safety profiles, and clinical trial outcomes of three targeted agents-bemarituzumab, zolbetuximab, and ramucirumab-which inhibit tumor growth through the FGFR2b, CLDN18.2, and VEGFR2 pathways, respectively. We also compare traditional versus adaptive clinical trial designs, explore emerging challenges such as therapeutic resistance and treatment-related toxicities, and consider implications for personalized medicine. Collectively, these agents represent a paradigm shift from empiric chemotherapy toward biomarker-driven immunotherapy, with the potential to significantly improve survival and quality of life in patients with advanced G/GEJ cancers.

P3, N=490, Active, not recruiting, Daiichi Sankyo | Trial completion date: Feb 2026 --> Aug 2026 | Trial primary completion date: Oct 2025 --> Aug 2026

P1/2, N=8, Active, not recruiting, Baylor Research Institute | Not yet recruiting --> Active, not recruiting | N=30 --> 8 | Trial completion date: Jun 2024 --> Jun 2026 | Trial primary completion date: Jun 2024 --> Dec 2024

P2, N=30, Active, not recruiting, Emory University | Trial primary completion date: Sep 2025 --> Sep 2026

Herein, we present a case in which treatment with erlotinib plus ramucirumab led to a complete response and progression-free survival of 13 months in a 79-year-old man with advanced NSCLC harboring EGFR exon 20 A763_Y763insFQEA. This case suggests that this regimen should be considered as an effective treatment option for such patients.

The anti-vascular endothelial growth factor receptor 2 (VEGFR2) antibody ramucirumab has shown promise in unresectable HCC with high serum alpha-fetoprotein (AFP) levels, but its efficacy after Atezolizumab/Bevacizumab is unclear. Furthermore, single-cell analysis demonstrated that DC101 suppresses CSCs by disrupting their interaction with ECs and induces alterations in the tumor immune microenvironment. VEGFR2-targeted therapy not only suppressed tumor angiogenesis but also inhibited CSCs and enhanced antitumor immune activity, suggesting its potential utility as a second-line treatment following Atezolizumab/Bevacizumab.

In patients with advanced HER2-negative gastric or gastroesophageal junction cancer, paclitaxel plus ramucirumab switch maintenance showed significant benefit in HRQOL, reducing symptoms and delaying global QOL deterioration.

P1, N=62, Terminated, Eli Lilly and Company | N=105 --> 62 | Completed --> Terminated