Indications
Ramucirumab is a prescription cancer medicine. It is used, alone or with chemotherapy or other targeted medicines, for advanced stomach cancer and cancer where the stomach joins the food pipe, advanced non-small cell lung cancer, metastatic colorectal (bowel) cancer, and advanced liver cancer (hepatocellular carcinoma) with a high blood level of alpha-fetoprotein, usually after earlier treatment. Treatment is decided by a cancer specialist.
How It Works
Ramucirumab is a monoclonal antibody, a laboratory-made protein that targets one specific molecule. It blocks VEGF receptor 2, a switch that tumours use to grow new blood vessels (angiogenesis). Without a good blood supply, the tumour receives less oxygen and nutrients, which helps slow its growth.
Dosage and Administration
Ramucirumab is given as an infusion into a vein (drip) over about 1 hour by a doctor or nurse in a hospital or cancer centre, usually every 2 or 3 weeks depending on the cancer and the combination used. The dose is based on body weight and is set by the specialist. An antihistamine is usually given before each infusion.
Interactions
No important drug interactions are known. Tell your doctor about all medicines, especially blood thinners such as Warfarin or Aspirin, as the bleeding risk may increase.
Contraindications
- Severe allergy to Ramucirumab or any ingredient
- For lung cancer: tumours that have cavities or that involve major blood vessels, because of the risk of serious bleeding
Side Effects
- High blood pressure, headache, tiredness
- Diarrhoea, stomach pain, mouth sores, nosebleeds
- Swelling of the legs, protein in the urine
- Low white blood cells or platelets (mostly when given with chemotherapy)
- Infusion reactions: chills, shaking, back pain, flushing or breathlessness during the drip
- Serious but less common: bleeding, a tear in the bowel or stomach wall (perforation), blood clots in arteries (heart attack, stroke), poor wound healing
Get urgent medical help if you have severe stomach pain, vomiting blood, black or bloody stools, coughing up blood, chest pain, sudden weakness or numbness of the face or limbs, difficulty speaking, a very severe headache with confusion or vision changes, or signs of a severe allergic reaction.
Pregnancy and Lactation
Ramucirumab may harm an unborn baby and should not be used in pregnancy. Women who could become pregnant should use effective contraception during treatment and for at least 3 months after the last dose. Do not breastfeed during treatment and for at least 3 months after the last dose.
Precautions and Warnings
- Blood pressure and urine protein are checked regularly.
- Treatment is usually stopped before planned surgery and restarted only after the wound has healed.
- Tell your doctor if you have liver cirrhosis, a recent bleed, heart disease or a history of stroke.
Overdose
Ramucirumab is given by health professionals, so overdose is unlikely. If it happens, the patient is monitored and given supportive care.
Therapeutic Class
Antineoplastic monoclonal antibody (VEGF receptor 2 antagonist, anti-angiogenic agent).
Storage
Hospital medicine. Store as directed on the pack, in a refrigerator at 2 to 8°C, in the original carton to protect from light; do not freeze or shake.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.