Monoclonal antibody
Type Whole antibody
Source Human
Target VEGFR2 (KDR)
Clinical data
Trade names Cyramza
Routes of
ATC code L01XC21 (WHO)
Legal status
Legal status
CAS Number 947687-13-0 N
ChemSpider none
Chemical and physical data
Formula C6374H9864N1692O1996S46
Molar mass 143.6 kg/mol
 NYesY (what is this?)  (verify)

Ramucirumab[1] (IMC-1121B, trade name Cyramza[2][3]) is a fully human monoclonal antibody (IgG1) developed for the treatment of solid tumors. This drug was developed by ImClone Systems Inc. It was isolated from a native phage display library from Dyax.

Mechanism of action

It is directed against the vascular endothelial growth factor receptor 2 (VEGFR2). By binding to VEGFR2 it works as a receptor antagonist blocking the binding of vascular endothelial growth factor (VEGF) to VEGFR2. VEGFR2 is known to mediate the majority of the downstream effects of VEGF in angiogenesis.[4]

Approved uses

On April 21, 2014, the FDA approved ramucirumab, as a single agent or with paclitaxel, for treatment of advanced gastric or gastro-esophageal junction adenocarcinoma if the disease has progressed despite fluoropyrimidine- or platinum-containing chemotherapy.[5][6]

On December 12, 2014, the FDA approved ramucirumab in combination with docetaxel, for treatment of metastatic non-small-cell lung carcinoma with disease progression on or after platinum-containing chemotherapy. If the cancer has a sensitizing mutation of EGFR or ALK previous therapy should have included targeted therapy for the genomic tumor aberration.[7]

Clinical trials

On September 26, 2013 the manufacturer Eli Lilly announced that its Phase III study for ramucirumab failed to hit its primary endpoint on progression-free survival among women with metastatic breast cancer.[8][9]

In June 2014, a phase III trial of the drug reported it failed to improve overall survival in liver cancer.[10]

In Feb 2016 it was reported that a phase II trial of adding ramucirumab to docetaxel improved progression-free survival (PFS) compared with docetaxel alone in locally advanced or metastatic urothelial carcinoma.[11] It is now in the RANGE phase III trial for this indication.[12]


  1. Statement On A Nonproprietary Name Adopted By The USAN Council - Ramucirumab, American Medical Association.
  2. FierceBiotech: FDA OKs Lilly's blockbuster hopeful ramucirumab for stomach cancer
  3. Cyramza official website
  4. Ramucirumab (Cyramza) package insert
  5. FDA.gov press release for ramucirumab approval, accessed April 22, 2014
  6. Ramucirumab gastric cancer regimen & reference
  7. Clinical trial number NCT00703326 for "Phase III Study of Docetaxel + Ramucirumab or Placebo in Breast Cancer" at ClinicalTrials.gov
  8. Fierce Biotech. "In another stinging setback, Eli Lilly's ramucirumab fails PhIII breast cancer study". Retrieved 27 September 2013.
  9. http://www.genengnews.com/gen-news-highlights/lilly-s-cyramza-fails-phase-iii-trial-in-liver-cancer/81249964/
  10. Ramucirumab Added to Docetaxel Extends PFS in Urothelial Carcinoma.Feb 2016
  11. A Study of Ramucirumab (LY3009806) Plus Docetaxel in Participants With Urothelial Cancer (RANGE)

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