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Background We performed a systematic review and meta-analysis of the risk of cardiovascular adverse events associated with ramucirumab. Patients and methods Eligible studies included randomized phase II and III trials of patients with solid tumors on ramucirumab; describing events of hypertension, bleeding, arterial/venous thrombosis and congestive heart failure. Results Our search strategy yielded 160 potentially relevant citations from Pubmed/Medline, CENTRAL Cochrane registry and ASCO meeting library. After exclusion of ineligible studies, a total of 11 clinical trials were considered eligible for the meta-analysis. The RR of all-grade hypertension, bleeding, ATE, VTE and congestive heart failure were 2.83 (95% CI 2.43–3.29; p < 0.0001), 1.98 (95% CI 1.77–2.21; p < 0.0001); 0.97 (95% CI 0.62–1.52; p = 0.91), 0.83 (95% CI 0.52–1.35; p = 0.46), 1.36 (95% CI 0.77-2.4; p = 0.28), respectively. Conclusions Our meta-analysis has demonstrated that ramucirumab is associated with an increased risk of hypertension and bleeding. Clinicians should be aware of this risk and perform regular clinical monitoring. [ABSTRACT FROM AUTHOR]

Background: We performed a systematic review and meta-analysis of the risk of proteinuria associated with ramucirumab. Methods: Eligible studies included randomized phase II and III trials of patients with solid tumors on ramucirumab, describing events of all-grade and high-grade proteinuria. Results: Our search strategy yielded 170 potentially relevant citations from PubMed/Medline, CENTRAL Cochrane database, ASCO and ESMO meeting libraries. After exclusion of ineligible studies, a total of 11 clinical trials were considered eligible for the meta-analysis. The relative risk (RR) of all-grade proteinuria was 3.31 (95% CI 2.48-4.42; p < 0.00001). Moreover, the RR of high-grade proteinuria was 5.28 (95% CI 2.32-12.01; p < 0.0001). Conclusions: Our meta-analysis has demonstrated that ramucirumab use is associated with an increased risk of all-grade and high-grade proteinuria. Early detection strategies should be employed in those patients to prevent the progression to more sinister renal disease. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: We performed a meta-analysis of the risk of hematological adverse events associated with ramucirumab.Methods: Eligible studies included randomized Phase II and III trials of patients with solid tumors on ramucirumab, describing events of anemia, leucopenia, neutropenia, febrile neutropenia and thrombocytopenia.Results: A total of 11 clinical trials were considered eligible for the meta-analysis. The relative risks of all-grade anemia, leucopenia, neutropenia, febrile neutropenia and thrombocytopenia were 0.88 (95% CI: 0.80-0.96; p = 0.007), 1.13 (95% CI: 0.85-1.49; p = 0.41), 1.25 (95% CI: 1.08-1.44; p = 0.002), 1.63 (95% CI: 1.30-2.06; p < 0.0001), 1.91 (95% CI: 1.52-2.42; p < 0.00001), respectively.Conclusion: Our meta-analysis has demonstrated an increased risk of febrile neutropenia, all-grade and high-grade neutropenia and thrombocytopenia with ramucirumab-based treatment compared with control. [ABSTRACT FROM AUTHOR]

Gastric (GC) and gastroesophageal junction (GEJ) cancers are two global health problems with a relatively high mortality, particularly in the advanced stage. Inhibition of angiogenesis is now contemplated as a classic treatment preference for myriad tumor types encompassing renal cell carcinoma, non-small cell lung cancer, colorectal cancer, glioblastoma, and ovarian cancer, among others. Bevacizumab and ramucirumab have been widely investigated in GC and GEJ cancer, with some controversy about their therapeutic role. Ramucirumab is a monoclonal antibody for vascular endothelial growth factor receptor-2, with demonstrated activity both as a monotherapy and as a part of combination strategy in the management of advanced GC/GEJ cancer. In this review article, we present a critical evaluation of the preclinical and clinical data underlying the use of this drug in this indication. Moreover, we provide a spotlight on the future perspectives in systemic therapy for advanced GC/GEJ cancer. [ABSTRACT FROM AUTHOR]