Search results for "ramucirumab"
showing 10 items of 23 documents
Systemic therapy and synergies by combination.
2013
After years of therapeutic nihilism due to the inefficacy of conventional cytotoxic chemotherapy, the multikinase inhibitor sorafenib was the first agent to demonstrate a significant improvement in the survival of patients with advanced hepatocellular carcinoma (HCC). However, survival benefits on sorafenib treatment remain modest in clinical practice and developing more effective systemic therapies is challenging. No other targeted agent or regimen has proven efficacy to improve survival in a phase III trial in the first- or second-line setting, and no standard treatment option currently exists outside of clinical trials for patients with acquired resistance or intolerance to sorafenib. In…
Navigating the new landscape of second‐line treatment in advanced hepatocellular carcinoma
2020
Abstract Sorafenib and lenvatinib are approved for first‐line treatment of patients with advanced hepatocellular carcinoma (HCC), and the efficacy of atezolizumab plus bevacizumab has been demonstrated versus sorafenib. Over time, first‐line treatment frequently fails, and regorafenib, cabozantinib, ramucirumab (for patients with alpha fetoprotein ≥400 ng/mL), nivolumab, pembrolizumab and ipilimumab plus nivolumab are approved for use after sorafenib (but not lenvatinib) treatment in advanced HCC. Given the considerable complexity in the therapeutic landscape, the objective of this review was to summarize the clinical evidence for second‐line agents and provide practical guidance for select…
How to Develop Molecular Targeted Drugs in Gastric Cancer: First or Second Line?
2013
The inclusion of new targeted drugs into treatment strategies of advanced or metastatic esophagogastric cancers (AGC) shows great promise, particularly with validated predictive biomarkers. The majority of agents already tested or in current phase III trials are targeting the epidermal growth factor receptor family (EGFR1/ HER2) or angiogenesis inhibitors. Against HER2, only trastuzumab (T) combined with first-line chemotherapy significantly improved overall survival (OS) in patients with HER2-overexpressing (HER+) tumors (ToGA). Despite first positive signals, the dual tyrosine kinase inhibitor (TKI) of HER2 and EGFR1 lapatinib did not reach primary endpoints in HER2+ tumors in first- and …
“Are There New Chemotherapy Drugs Behind the Corner?”
2018
Up to now, the backbone of both adjuvant and palliative chemotherapy for colorectal cancer is still represented by 5-fluorouracil (5FU). However, we have currently several approved drugs with significant clinical activity in metastatic colon cancer. Apart from cytotoxics such as oxaliplatin, irinotecan, and fluoropyrimidines, we have antiangiogenics (bevacizumab, aflibercept, and ramucirumab), anti-epidermal growth factor receptor (EGFR), and tyrosine kinase inhibitors such as regorafenib. Despite remarkable prolongation of median survival, exceeding 24 months, most patients will be progressing over different lines of therapy, and there is a need and a role for new compounds to be added to …
Update of REVEL: A randomized, double-blind, phase III study of docetaxel (DOC) and ramucirumab (RAM; IMC-1121B) versus DOC and placebo (PL) in the s…
2015
Nintedanib in non-small cell lung cancer: from preclinical to approval
2015
Angiogenesis is a driving force of a tumor’s development. Targeting this process is an attractive option, as this is a feature shared by most of the solid tumors. A lot of antiangiogenic drugs have been developed following this path, including bevacizumab, sorafenib, sunitinib, vandetanib, ramucirumab, motesanib and many others. The latest drug of this class to be approved for patients with non-small cell lung cancer (NSCLC) was nintedanib, a triple angiokinase inhibitor. This molecule targets vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF) and fibroblast growth factor (FGF) pathways, avoiding the tumor’s switch to normal escape mechanisms. The pharmacokine…
Optimizing Sequential Systemic Therapies for Advanced Hepatocellular Carcinoma: A Decision Analysis
2020
Background: An optimal sequential systemic therapy for advanced hepatocellular carcinoma (HCC) has not been discovered. We developed a decision model based on available clinical trials to identify an optimal risk/benefit strategy for sequences of novel systemic agents. Methods: A Markov model was built to simulate overall survival (OS) among patients with advanced HCC. Three first-line (single-agent Sorafenib or Lenvatinib, and combination of Atezolizumab plus Bevacizumab) followed by five second-line treatments (Regorafenib, Cabozantinib, Ramucirumab, Nivolumab, Pembrolizumab) were compared in fifteen sequential strategies. The likelihood of transition between states (initial treatment, ca…
Systemic therapy for intermediate and advanced hepatocellular carcinoma: Sorafenib and beyond.
2018
The hepatocellular carcinoma (HCC) treatment landscape changed a decade ago, with sorafenib demonstrating survival benefit in the first-line setting and becoming the first systemic therapy to be approved for HCC. More recently, regorafenib and nivolumab have received approval in the second-line setting after sorafenib, with further positive phase 3 studies emerging in the first line (lenvatinib non-inferior to sorafenib) and second line versus placebo (cabozantinib and ramucirumab). A key recommendation in the management of patients receiving sorafenib is to promote close communication between the patient and the physician so that adverse events (AEs) are detected early and severe AEs can b…
Ramucirumab in elderly patients with hepatocellular carcinoma and elevated alpha-fetoprotein after sorafenib in REACH and REACH-2.
2020
Background & Aims: Limited data on treatment of elderly patients with hepatocellular carcinoma (HCC) increase the unmet need. REACH and REACH-2 were global phase III studies of ramucirumab in patients with HCC after prior sorafenib, where patients with alpha-fetoprotein (AFP) ≥400 ng/mL showed an overall ssurvival (OS) benefit for ramucirumab. These post-hoc analyses examined efficacy and safety of ramucirumab in patients with HCC and baseline AFP ≥ 400 ng/mL by three prespecified age subgroups (<65, ≥65 to <75 and ≥75 years). Methods: Individual patient data were pooled from REACH (baseline AFP ≥400 ng/mL) and REACH-2. Kaplan-Meier and Cox proportional hazards regression methods …