OnCo
drugsProductApproved2014🇪🇺🇬🇧🇯🇵🇨🇳🇦🇺

Ramucirumab

An antibody that blocks the VEGF receptor, approved in liver cancer only for patients with a high AFP blood level, the first biomarker-selected HCC drug.

REACH-2: OS 8.5 vs 7.3 months in sorafenib-pretreated HCC with AFP ≥400 ng/mL (HR 0.71), after REACH failed in unselected patients. Also approved in gastric (RAINBOW), NSCLC (REVEL, with erlotinib in EGFR-mutant) and colorectal cancer (RAISE).

Schematic of the modality · Monoclonal antibody (anti-VEGFR2) · not a molecule; see the Monoclonal antibodies page
Mechanism, step by step
auto-advancing · hover to pause

1.Ramucirumab binds VEGFR2 on blood-vessel cells

Modality
Monoclonal antibody (anti-VEGFR2)
Mechanism
Fully human IgG1 binding VEGFR2 ectodomain, blocking VEGF-A/C/D signalling.
Brand / code
Cyramza
Dosing & schedule
Route
Intravenous
Schedule
8 mg/kg every 2 weeks
Medicare
Part B (clinician-administered)

Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies.

Commercial insurance
covered with prior authorisation

Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.

Assistance programmes

20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.

Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.

Not recommendedNICE TA378 · 2016
Appraised for
Advanced gastric or gastro-oesophageal junction cancer after chemotherapy
Notes
Also not recommended for NSCLC (TA403, 2016). HCC with high AFP appraised later. Not routinely available on the NHS.

Sources: NICE TA378. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.

Regulatory

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Approvals

RegionYearIndication
US2014Gastric cancer; NSCLC
US2019HCC with AFP ≥400 ng/mL after sorafenib
US2014Second-line advanced gastric/GEJ cancer alone or with paclitaxel
US2014NSCLC with docetaxel; 2015 mCRC with FOLFIRI; 2019 HCC AFP ≥400; 2020 EGFR-mutant NSCLC with erlotinib

Safety

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Toxicity profile
Adverse eventAny gradeGrade 3+
Hypertension
25%
13%
Proteinuria
20%
2%
Hypertension
Proteinuria
Bleeding/epistaxis
Neutropenia (with paclitaxel)

REACH-2. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.

Trials

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ClinicalTrials.gov · phase 2/3
refreshed 2026-09-09
138 studies16 recruiting82 Phase 223 Phase 3
Search “Ramucirumab” on ClinicalTrials.gov →
Counts are from a name search and may include unrelated studies; up to 100 studies are summarised.

Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Ramucirumab
intervention: Ramucirumab
Open on ClinicalTrials.gov →

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Landmark trials in OnCo

Latest papers

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Literature trend102 papers in the last 12 months-6% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this drug: (TITLE:"Ramucirumab" OR ABSTRACT:"Ramucirumab" OR TITLE:"Cyramza" OR ABSTRACT:"Cyramza") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ramucirumab, not a curated reading list.

Connected

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