Cyramza (ramucirumab)

EGFR tyrosine kinase inhibitors, including osimertinib, generally exhibit lower efficacy in patients with the L858R-mutant NSCLC compared with those with exon 19 deletion (del19). Grade more than or equal to 3 adverse events occurred in 42% of patients. In real-world settings, RAM plus ERL demonstrated favorable efficacy in patients with L858R-mutant NSCLC and manageable toxicity.

He subsequently received ramucirumab-based therapy, paclitaxel, and irinotecan...Pembrolizumab combined with capecitabine and oxaliplatin (CAPOX) was initiated as fifth-line therapy, resulting in notable regression of hepatic and nodal metastases. This case underscores the clinical importance of early MSI/MMR and genomic testing and suggests that re-administration of ICI plus chemotherapy may be a therapeutic option for selected patients with advanced gastric cancer who initially show limited response to ICI-based therapy.

P1/2, N=43, Not yet recruiting, AstraZeneca AB

P1/2, N=210, Recruiting, Merck Sharp & Dohme LLC | Trial primary completion date: Dec 2026 --> May 2028

P2/3, N=1, Completed, Eli Lilly & Co. | Active, not recruiting --> Completed

Conversion surgery after nivolumab combination chemotherapy may be feasible in selected patients with AFP-EGJC with liver metastasis.

The patient was diagnosed with T4b(pancreas)N2M0, CY0P0, cStage ⅣA, and after 3 courses of docetaxel+oxaliplatin+S‒1(DOS)therapy as preoperative chemotherapy, laparoscopic distal gastrectomy with D2 lymph node dissection and Roux‒en‒Y reconstruction were performed...Tumor markers elevated and CT scan showed ascites after 5 courses and the treatment was consequently changed to paclitaxel+ramucirumab(PTX+Ram)therapy as second‒line treatment...Four years after the initial onset, the patient is currently alive without recurrence. No serious adverse events have occurred since the start of Pem monotherapy.

The target population for these recommendations is patients with unresectable locally advanced, advanced, or metastatic gastroesophageal cancer. Results from testing for actionable biomarkers should be available as soon as possible to inform treatment decision making. Immunotherapy with doublet chemotherapy is recommended for patients with proficient mismatch repair (pMMR)/microsatellite stable (MSS) human epidermal growth factor receptor 2 (HER2)-negative gastroesophageal adenocarcinoma or squamous cell carcinoma and PD-L1 expression ≥1; patients with higher PD-L1 expression are more likely to benefit from immunotherapy. Zolbetuximab is recommended for patients with gastroesophageal adenocarcinoma, PD-L1 <1, and positive CLDN18.2 expression. Patients with dual PD-L1 and CLDN18.2 positivity should engage in shared decision making, considering the factors outlined in the guideline. Doublet chemotherapy alone is recommended for patients who are not positive for actionable biomarkers or are not considered candidates for targeted therapy or immunotherapy. For patients with pMMR/MSS HER2-positive gastric/gastroesophageal junction (GEJ) adenocarcinoma, trastuzumab and doublet chemotherapy is recommended; for patients with PD-L1 expression ≥1, the addition of pembrolizumab is recommended. Immunotherapy alone or with doublet chemotherapy is recommended for patients with mismatch repair deficient/microsatellite instability-high gastroesophageal cancer. Second-line therapy options include ramucirumab with paclitaxel, trastuzumab deruxtecan for HER2-positive gastric/GEJ adenocarcinoma, and immunotherapy for PD-L1 ≥1 esophageal squamous cell carcinoma after first-line combination chemotherapy without immunotherapy.Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines.

Two treatment strategies were compared: ramucirumab plus paclitaxel versus continuation of oxaliplatin-based chemotherapy (FOLFOX/CAPOX)...At current pricing and under the existing PAP framework, ramucirumab plus paclitaxel is not a cost-effective switch maintenance strategy in advanced HER2-negative gastric or gastroesophageal junction cancer in China. Significant price reductions through national negotiations may enable this regimen to become economically viable within the Chinese healthcare system.

By blocking the mechanisms that lead to angiogenesis and tumor growth, first-line systemic treatments, such the multi-tyrosine kinase inhibitors (TKIs) lenvatinib and sorafenib, have shown moderate improvements in survival. However, their long-term efficacy is significantly reduced by intrinsic and acquired resistance, which is why second-line medications like regorafenib, cabozantinib, and ramucirumab are being studied. When combined with anti-VEGF treatments, parallel developments in immunotherapy, in particular immune checkpoint inhibitors (ICIs) such as atezolizumab and nivolumab, have shown promising outcomes...In the end, the review promotes the combination of dynamic molecular profiling and biomarker-driven precision medicine to enhance patient stratification, improve treatment decision-making, and provide long-lasting clinical effects. A strategic foundation for future advancements and individualized treatment of hepatocellular carcinoma is provided by this comprehensive synthesis.

P1/2, N=200, Recruiting, UZ Leuven