Efficacy and safety of ramucirumab treatment in patients with advanced colorectal cancer

Ju, Man Ki; Cheng, Honggang; Qu, Kai; Lu, Xiangqian

doi:10.1097/md.0000000000020618

Cited by 6 publications

(8 citation statements)

References 38 publications

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“…The sensitivity analysis will be performed by removing 1 study each time from pooled analysis followed by reporting the results in a summary table. [ 12 ]…”

Section: Methodsmentioning

confidence: 99%

Shunting outcomes in post-hemorrhagic hydrocephalus

Guan¹,

You²,

Yang³

et al. 2020

Medicine

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Background: The best treatment option for patients with post-hemorrhagic hydrocephalus (PHH) remains controversial. The objective of the current meta-analysis is to systematically evaluate the long-term outcomes of patients with PHH treated by ventriculoperitoneal shunt (VPS) and lumboperitoneal shunt (LPS). Methods: We search literatures through PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan fang databases, and Chinese Biomedical Literature Database (CBM) from its beginning to June 15, 2020. Randomized controlled trials (RCTs) and non-RCTs in English or Chinese studies will be considered. The primary outcome is the rate of shunt failure after shunt implantation The secondary outcome is the rate of complications that are associated with shunt surgery. Results and conclusion: The study will compare the 2 types of shunt surgery in the treatment of PHH, providing evidence for the treatment option for the patients with PHH. Study registration number: The study is priorly registered through International Platform of Registered Systematic Review and Meta-analysis Protocols on June 17, 2020 (INPLASY202060063).

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“…The sensitivity analysis will be performed by removing 1 study each time from pooled analysis followed by reporting the results in a summary table. [ 12 ]…”

Section: Methodsmentioning

confidence: 99%

Shunting outcomes in post-hemorrhagic hydrocephalus

Guan¹,

You²,

Yang³

et al. 2020

Medicine

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“…In combination with FOLFIRI chemotherapy, Aflibercept has also shown increased survival rates in patients with mCRC 201 . Other approved treatments targeting angiogenesis in mCRC include ramucirumab, a VEGFR‐2 extracellular domain‐binding, fully humanized immunoglobulin G1 monoclonal antibody that acts to inhibit VEGF ligand binding 202 . An alternative option to these is regorafenib, which acts to block angiogenic tyrosine kinases (VEGFR‐1 and VEGFR‐3) amongst other pathways 17 …”

Section: Role Of the Tumor Microenvironment Within Colorectal Cancermentioning

confidence: 99%

“…201 Other approved treatments targeting angiogenesis in mCRC include ramucirumab, a VEGFR-2 extracellular domain-binding, fully humanized immunoglobulin G1 monoclonal antibody that acts to inhibit VEGF ligand binding. 202 An alternative option to these is regorafenib, which acts to block angiogenic tyrosine kinases (VEGFR-1 and VEGFR-3) amongst other pathways. 17 Despite anti-VEGF therapy for mCRC becoming widely adopted, this still presents several challenges including anti-angiogenic therapy resistance, which is thought to be largely correlated with tumor endothelial cell (TEC) heterogeneity.…”

Section: Anti-tgf-β Strategies In Colorectal Cancer Stromal Cellsmentioning

confidence: 99%

The emerging era of personalized medicine in advanced colorectal cancer

Reid

Leedham

et al. 2022

J of Gastro and Hepatol

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Colorectal cancer (CRC) is a genetically heterogeneous disease with its pathogenesis often driven by varying genetic or epigenetic alterations. This has led to a substantial number of patients developing chemoresistance and treatment failure, resulting in a high mortality rate for advanced disease. Deep molecular analysis has allowed for the discovery of key intestinal signaling pathways which impacts colonic epithelial cell fate, and the integral role of the tumor microenvironment on cancer growth and dissemination. Through transitioning pre‐clinical knowledge in research into clinical practice, many potential druggable targets within these pathways have been discovered in the hopes of overcoming the roadblocks encountered by conventional therapies. A personalized approach tailoring treatment according to the histopathological and molecular features of individual tumors can hopefully translate to better patient outcomes, and reduce the rate of recurrence in patients with advanced CRC. Herein, the latest understanding on the molecular science behind CRC tumorigenesis, and the potential treatment targets currently at the forefront of research are summarized.

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“…About 25% of patients with metastatic CRC (mCRC) are diagnosed initially due to the lack of visible clinical signs and symptoms (3,4). Patients with metastasis have a poor prognosis and a median overall survival (OS) of 30 months (5).…”

Section: Introductionmentioning

confidence: 99%

“…Ramucirumab is a fully human IgG1 monoclonal antibody that binds to VEGF receptor 2 (VEGFR-2), obstructing VEGF-A, -C, and -D ligand binding, thereby inhibiting tumor angiogenesis (9). Based on the results from the global phase 3 RAISE trial, ramucirumab was approved for second-line mCRC treatment in combination with levofolinate, fluorouracil, and irinotecan (FOLFIRI) in the United States, European Union, and Japan (4,10). The RAISE trial showed a median OS of 13.3 months in patients treated with ramucirumab + FOLFIRI versus 11.7 months in placebo + FOLFIRI [hazard ratio: 0.844; 95% confidence interval (CI): 0.73-0.98; log-rank P=0.02] (10).…”

Section: Introductionmentioning

confidence: 99%

A post-marketing safety study of ramucirumab with FOLFIRI in patients with metastatic colorectal cancer

Masuishi¹,

Nagaoka²,

Jin³

et al. 2022

J Gastrointest Oncol

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Background: Ramucirumab [human vascular endothelial growth factor (VEGF) receptor-2 monoclonal antibody] + levofolinate, fluorouracil, and irinotecan (FOLFIRI) was approved for the treatment of metastatic colorectal cancer (CRC) in Japan based on the results from the phase 3 RAISE trial (NCT01183780).However, safety information of ramucirumab + FOLFIRI in the real-world setting is limited. Therefore, the present study was conducted to evaluate the safety of ramucirumab + FOLFIRI under routine clinical practice in patients with metastatic CRC (mCRC) after first-line chemotherapy.Methods: A single-arm, prospective, multicenter, non-interventional, observational study was conducted between August 2016 and May 2020. Patients with mCRC treated with ramucirumab + FOLFIRI for the first time were included. Patients were observed for 12 months from the start of ramucirumab. Data were recorded using the electronic data capture system.Results: In total, 362 patients with a mean age of 64.1 years were evaluated for safety, of whom 355 patients were evaluated for effectiveness. A higher proportion of the patients were males (n=200; 55.2%), had metastases and recurrent sites (n=362, 100.0%), and had received prior anti-cancer treatment (n=355; 98.1%).Approximately 83.7% (n=303) and 25.4% (n=92) of patients had medication history of bevacizumab and anti-epidermal growth factor receptor (EGFR) antibodies, respectively. Overall, 84.3% (n=305) of patients experienced any grade adverse events (AEs). Neutrophil count decreased (n=138; 38.1%), hypertension (n=58; 16.0%), and diarrhea (n=57; 15.7%) were observed frequently. The clinically relevant grade ≥3 AEs of special interest (AESIs) with >2% incidence included neutropenia (n=101; 27.9%), hypertension (n=35; 9.7%), proteinuria (n=23; 6.4%), hepatic dysfunction (n=15; 4.1%), febrile neutropenia (n=10; 2.8%), and leukopenia (n=9; 2.5%). The presence of renal disease at baseline increased the risk of proteinuria [risk ratio: 2.1; 95% confidence interval (CI): 1.1-4.2]. Three deaths were reported due to AEs, of which 1 was study treatment related. The 12-month survival rate of the ramucirumab + FOLFIRI regimen was 59%, mortality mainly (90%) occurring due to progressive disease. Conclusions:Although the current observational study enrolled patients with various medication history, the regimen of ramucirumab + FOLFIRI was manageable under clinical practice. No new safety concerns beyond the findings observed in previous clinical trials were reported.

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Efficacy and safety of ramucirumab treatment in patients with advanced colorectal cancer

Cited by 6 publications

References 38 publications

Shunting outcomes in post-hemorrhagic hydrocephalus

Shunting outcomes in post-hemorrhagic hydrocephalus

The emerging era of personalized medicine in advanced colorectal cancer

A post-marketing safety study of ramucirumab with FOLFIRI in patients with metastatic colorectal cancer

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