Ramucirumab, as a
vascular endothelial growth factor receptor-2 inhibitor, was first approved in 2014 for treated advanced or metastatic gastric/gastroesophageal junction (GEJ)
adenocarcinoma. This study deeply analyzed the efficacy and safety of advanced or metastatic
cancer treated with
ramucirumab, which included 11 global, double-blind, phase 3 randomized controlled trials with a total of 7410 patients. Subgroup analysis based on different
cancer types showed that standard regimens plus
ramucirumab significantly increased progression-free survival and overall survival compared with placebo groups in patients with advanced
non-small-cell lung cancer (NSCLC),
hepatocellular carcinoma,
gastric cancer, or GEJ
adenocarcinoma. Although a higher proportion of patients achieved overall response and disease control than those treated with placebo, the overall response was not statistically significant between the two groups in advanced NSCLC. Grade 3 or worse treatment-emergent adverse events (TEAEs) that occurred in at least 5% of patients were
neutropenia (30.5% in the
ramucirumab group vs. 23.5% in the placebo group), leucopenia (14.8% vs. 9.2%), weight decreased (14.2% vs. 8.0%),
myalgia (11.7% vs. 7.7%),
fatigue (10.9% vs. 7.7%),
hypertension (9.2% vs. 2.3%), and anaemia (6.2% vs. 7.7%). In the TEAEs of special interest, the
ramucirumab group had a significantly higher incidence of
bleeding (mainly grade 1-2
epistaxis and gastrointestinal
bleeding),
hypertension,
proteinuria, liver injury/failure (grade 1-2),
venous thromboembolism (grade 1-2), and gastrointestinal perforation (grade ≧3) than the control group.