FDA approves Ramucirumab for unresectable or metastatic advanced gastric cancer or GE junction adenocarcinoma.
The FDA has approved the angiogenesis inhibitor ramucirumab (Cyramza) for the treatment of advanced stomach cancer or gastroesophageal (GE) junction adenocarcinoma in patients with unresectable or metastatic disease following therapy with a fluoropyrimidine- or platinum-containing regimen. This agent has also been designated as an orphan product.
Approval was based on 2 clinical trials. A study of 355 patients showed that those treated with ramucirumab (two thirds of patients) had better median overall survival (5.2 vs 3.8 mo) and better progression-free survival compared with patients who received placebo. A second study that compared the efficacy of ramucirumab plus paclitaxel with that of paclitaxel alone also showed improved overall survival in the group that received ramucirumab.
The most common adverse events associated with ramucirumab included diarrhea and hypertension.
Diagnoisis : Biopsy of any ulcerated lesion should include at least 6 specimens taken from around the lesion because of variable malignant transformation. In selected cases, endoscopic ultrasonography may be helpful in assessing depth of penetration of the tumor or involvement of adjacent structures.
Histologically, adenocarcinoma of the stomach constitutes 90-95% of all gastric malignancies, followed by lymphomas (1-5%), gastrointestinal stromal tumors (formerly classified as either leiomyomas or leiomyosarcomas) (2%), carcinoids (1%), adenoacanthomas (1%), and squamous cell carcinomas (1%).
Courtesy: Daniel M Beyerbach, MD, PhD, Elwyn C Cabebe, MD, http://emedicine.medscape.com/article/278744-overview?src=wnl_ref_prac_imed&uac=192123MZ