Considering Efficacy and Cost, Where Does Ramucirumab Fit in the Management of Metastatic Colorectal Cancer?

Buen análisis del pobrísimo resultado terapéutico de las terapia dirigidas en segunda línea de cáncer de colon avanzado

Ramucirumab, a monoclonal antibody against vascular endothelial growth factor receptor 2 (VEGFR2) recently gained approval by the U.S. Food and Drug Administration (FDA) for use in gastric and lung cancer [1–3]. Based on safety and efficacy, it was subsequently approved in April 2015 by the FDA for use in metastatic colorectal cancer.

The RAISE trial, a randomized phase III trial, confirmed the benefit from ramucirumab in colorectal cancer after progression on bevacizumab, oxaliplatin, and a fluoropyrimidine [4]. A total of 1,072 patients with metastatic colorectal cancer who had progressed on FOLFOX plus bevacizumab were randomized to receive either FOLFIRI plus ramucirumab or FOLFIRI plus placebo. The trial demonstrated a median overall survival (OS) benefit of 1.6 months (hazard ratio [HR]: 0.84) with the use of ramucirumab.

The control arm of the study (FOLFIRI) is not the current standard of care in the U.S.

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