Ramucirumab in Non-small Cell Lung Cancer

Abstract

Lung cancer is one of the most prevalent and serious public-health problems in many countries, including Thailand. Non-Small Cell Lung Cancer (NSCLC) is the most common type of lung cancer. Smoking is the most significant risk factor for lung cancer. Ramucirumab is a fully human IgG1 monoclonal antibody, which specifically prevents binding between VEGF and VEGFR-2. This interaction inhibits the formation of new blood vessels that support the growth of cancer. The standard treatment is 10 mg/kg of ramucirumab every 2 weeks, together with 150 mg/day erlotinib or 75 mg/m² docetaxel every 21-day cycle. Patients are treated until disease progresses or drug toxicity becomes unacceptable. The most serious adverse events are gastrointestinal perforation, severe gastrointestinal hemorrhage, and arterial thromboembolic events. The most common adverse drug reactions include neutropenia, fatigue/asthenia, leukopenia, epistaxis, and diarrhea. Mucositis is not necessarily involved. Ramucirumab dosage should be adjusted for patients with impaired renal and hepatic function. Age, gender, ethnicity, body weight, and blood albumin level have no effect on the metabolism of ramucirumab (Thai Cancer J 2020;40:107-118)