What is Ramucirumab: Uses, Dosage, Side Effects and More

Ramucirumab is a targeted cancer medication that helps slow tumor growth by cutting off the blood supply that feeds cancer cells. It's what doctors call a monoclonal antibody - essentially a lab-made protein that acts like your body's natural immune system to fight specific targets in cancer.

This medication works differently from traditional chemotherapy drugs. Instead of attacking all rapidly dividing cells, ramucirumab specifically targets proteins that help tumors create new blood vessels, which is a more precise approach to cancer treatment.

What is Ramucirumab Used For?

Ramucirumab treats several types of advanced cancers, particularly when other treatments haven't worked as well as hoped. Your oncologist prescribes this medication for specific situations where blocking blood vessel growth can help control cancer progression.

The main cancers ramucirumab treats include advanced stomach cancer, certain types of lung cancer, and colorectal cancer that has spread to other parts of the body. It's often used alongside other cancer medications rather than by itself.

Your doctor might recommend ramucirumab when your cancer has progressed despite previous treatments, or as part of a combination therapy plan. Each situation is unique, and your oncologist will explain exactly why this medication fits your specific treatment plan.

How Does Ramucirumab Work?

Ramucirumab blocks a protein called VEGFR-2 that tumors use to grow new blood vessels. Think of it as cutting off the supply lines that feed cancer cells the nutrients they need to grow and spread.

This medication is considered a moderately strong targeted therapy. It's not as harsh on your whole body as traditional chemotherapy, but it's still a powerful medication that requires careful monitoring by your healthcare team.

The drug works by binding to specific receptors on blood vessel cells, preventing them from receiving growth signals. This helps starve tumors of the blood supply they need, which can slow their growth and spread.

How Should I Take Ramucirumab?

Ramucirumab is given only through an IV infusion at your doctor's office or infusion center. You cannot take this medication at home - it requires professional medical supervision every time you receive it.

The infusion typically takes about 60 minutes for your first dose, and your healthcare team will monitor you closely during this time. If you tolerate the first infusion well, future doses might be given over 30 minutes.

You don't need to make any special dietary changes before your infusion, but staying well-hydrated by drinking plenty of water in the days leading up to your treatment can help your body handle the medication better. Your healthcare team will give you specific instructions about eating and drinking before your appointment.

Before each infusion, you'll likely receive pre-medications to help prevent allergic reactions. These might include antihistamines or other medications to make your treatment more comfortable.

How Long Should I Take Ramucirumab For?

The length of ramucirumab treatment varies greatly from person to person and depends on how well your cancer responds and how your body tolerates the medication. Some people receive it for several months, while others might need it for a longer period.

Your oncologist will schedule regular scans and blood tests to monitor how well the treatment is working. These check-ups help determine whether to continue, adjust, or stop the medication based on your cancer's response.

Treatment typically continues until your cancer progresses, side effects become too difficult to manage, or you and your doctor decide it's time to try a different approach. This decision is always made together based on your overall health and treatment goals.

What Are the Side Effects of Ramucirumab?

Like all cancer medications, ramucirumab can cause side effects, though not everyone experiences them the same way. Your healthcare team will monitor you closely and help manage any issues that arise.

The most common side effects you might experience include fatigue, decreased appetite, and changes in your blood pressure. Many people also notice some swelling in their hands or feet, which is usually manageable with proper care.

Here are the more common side effects that affect many people taking ramucirumab:

• High blood pressure that may require medication
• Fatigue or feeling more tired than usual
• Decreased appetite and possible weight loss
• Headaches
• Swelling in hands, feet, or legs
• Diarrhea or changes in bowel movements
• Nausea without necessarily vomiting

These common side effects are usually manageable with supportive care and medications when needed. Your healthcare team has experience helping patients navigate these challenges.

There are also some less common but more serious side effects that require immediate medical attention. While these don't happen to most people, it's important to know what to watch for so you can get help quickly if needed.

Serious side effects that need immediate medical care include:

• Severe bleeding anywhere in your body
• Blood clots that can cause chest pain or shortness of breath
• Severe allergic reactions during infusion
• Problems with wound healing if you need surgery
• Serious infections due to lowered white blood cell counts
• Kidney problems that show up in blood tests

Your healthcare team will monitor you closely for these serious effects through regular blood tests and check-ups. Most people don't experience these severe complications, but knowing what to watch for helps ensure you get prompt care if needed.

Who Should Not Take Ramucirumab?

Ramucirumab isn't suitable for everyone, and your oncologist will carefully review your medical history before recommending this treatment. Certain health conditions or situations make this medication too risky to use safely.

You should not receive ramucirumab if you're pregnant or planning to become pregnant, as it can seriously harm a developing baby. Women who can become pregnant need to use effective birth control during treatment and for several months afterward.

People with recent major surgery, active bleeding, or severe blood clotting disorders typically cannot receive ramucirumab. Your doctor will also be cautious if you have uncontrolled high blood pressure or serious heart problems.

Other conditions that might make ramucirumab unsuitable include severe kidney disease, recent heart attack or stroke, or a history of serious bleeding problems. Your healthcare team will evaluate all these factors before starting treatment.

Ramucirumab Brand Names

Ramucirumab is sold under the brand name Cyramza. This is the only brand name available for this medication, as it's a specialty biologic drug made by one manufacturer.

When you receive your treatment, the medication vial will be labeled as Cyramza, but your medical team will often refer to it by its generic name, ramucirumab. Both names refer to the same medication.

Ramucirumab Alternatives

Several other medications work similarly to ramucirumab by targeting blood vessel growth in tumors. Your oncologist might consider these alternatives if ramucirumab isn't suitable for your situation or if you need a different treatment approach.

Bevacizumab is another anti-angiogenic drug that works by blocking VEGF rather than VEGFR-2. It's used for many of the same cancer types and might be an option depending on your specific diagnosis and treatment history.

Other targeted therapies like aflibercept or regorafenib might also be considered for certain types of cancer. Your oncologist will choose the best option based on your cancer type, previous treatments, and overall health status.

The choice between these medications depends on many factors, including which cancers they're approved to treat, how they interact with other drugs you're taking, and your individual risk factors for side effects.

Is Ramucirumab Better Than Bevacizumab?

Both ramucirumab and bevacizumab are effective anti-angiogenic medications, but they work slightly differently and are used for different situations. Neither is universally "better" - the choice depends on your specific cancer type and treatment history.

Ramucirumab blocks the VEGFR-2 receptor directly, while bevacizumab blocks the VEGF protein that binds to that receptor. This difference in mechanism might make one more suitable than the other for your particular situation.

For stomach cancer, ramucirumab has shown specific benefits that have made it a preferred choice in many cases. However, bevacizumab might be better for other cancer types or situations where ramucirumab isn't appropriate.

Your oncologist will consider factors like your cancer type, previous treatments, side effect profile, and overall health when choosing between these medications. The "better" choice is always the one that's most likely to help your specific situation.