Cyramza (ramucirumab)

P1/2, N=30, Active, not recruiting, Eli Lilly and Company | Trial completion date: Oct 2025 --> Oct 2026

FOLFIRI with low-dose irinotecan plus RAM is a feasible second-line treatment in Japanese patients with mCRC.

The angiogenesis inhibitors indicated for mCRC in France (ie, bevacizumab, aflibercept, ramucirumab, and regorafenib) were considered. No associations were found with either recency or cumulative duration of exposure, regardless of the exposure estimation method. In this case-control study of arterial dissections or aneurysms in patients receiving targeted therapy for mCRC, the lack of association with angiogenesis inhibitor exposure was reassuring, given the established benefits of these drugs, particularly bevacizumab, for this indication.

Patients received RAM (10 mg/kg every 2 wk) plus GEF (250 mg once daily) until disease progression (period 1); patients with disease progression who acquired a T790M mutation received RAM plus osimertinib (80 mg once daily) (period 2). Treatment-emergent T790M rate post progression was 81.3%. RELAY+ revealed a favorable benefit-risk profile for RAM plus GEF in East Asian patients with untreated EGFR-mutated metastatic NSCLC, supporting RAM plus GEF as an alternative first-line treatment option, particularly in those with an L858R mutation.

P3, N=572, Recruiting, AstraZeneca | Trial completion date: Apr 2027 --> Sep 2026 | Trial primary completion date: Oct 2026 --> May 2026

Paired peripheral blood mass cytometry revealed lower proportions of myeloid-derived suppressor cells in responders. Together these data highlight on-treatment remodeling under the therapeutic pressure of dual VEGF and PD-1 blockade, and suggest features associated with the durable benefit seen in a subset of patients.

In patients receiving immune checkpoint inhibitors, consider myocarditis in atypical Takotsubo presentations; biopsy and early steroids improve outcomes.

This review examines the mechanisms, safety profiles, and clinical trial outcomes of three targeted agents-bemarituzumab, zolbetuximab, and ramucirumab-which inhibit tumor growth through the FGFR2b, CLDN18.2, and VEGFR2 pathways, respectively. We also compare traditional versus adaptive clinical trial designs, explore emerging challenges such as therapeutic resistance and treatment-related toxicities, and consider implications for personalized medicine. Collectively, these agents represent a paradigm shift from empiric chemotherapy toward biomarker-driven immunotherapy, with the potential to significantly improve survival and quality of life in patients with advanced G/GEJ cancers.

P3, N=490, Active, not recruiting, Daiichi Sankyo | Trial completion date: Feb 2026 --> Aug 2026 | Trial primary completion date: Oct 2025 --> Aug 2026

P1/2, N=8, Active, not recruiting, Baylor Research Institute | Not yet recruiting --> Active, not recruiting | N=30 --> 8 | Trial completion date: Jun 2024 --> Jun 2026 | Trial primary completion date: Jun 2024 --> Dec 2024

P2, N=30, Active, not recruiting, Emory University | Trial primary completion date: Sep 2025 --> Sep 2026

Herein, we present a case in which treatment with erlotinib plus ramucirumab led to a complete response and progression-free survival of 13 months in a 79-year-old man with advanced NSCLC harboring EGFR exon 20 A763_Y763insFQEA. This case suggests that this regimen should be considered as an effective treatment option for such patients.