#高警訊藥品

大腸直腸癌、胃癌、非小細胞肺癌
Colorectal cancer (metastatic); Gastric cancer (advanced/metastatic); Non-small cell lung cancer (metastatic)

Antineoplastic Agent, Vascular Endothelial Growth Factor (VEGF) Inhibitor
Ramucirumab has a high affinity for VEGFR2, binding to it and blocking binding of VEGFR ligands, VEGF-A, VEGF-C, and VEGF-D to inhibit activation of VEGFR2, thereby inhibiting ligand-induced proliferation and migration of endothelial cells. VEGFR2 inhibition results in reduced tumor vascularity and growth.

1. Half-life elimination: 14 days
2. Distribution: Vdss 5.4 L
3. Excretion: Clearance 0.015 L/hour

Hypersensitivity to ramucirumab or any component of the formulation.

Fetal risk cannot be ruled out

Infant risk cannot be ruled out

Common:
Hypertension, Diarrhea, Neutropenia, Epistaxis, Fatigue
Serious:
Impaired wound healing, Bowel obstruction, Gastrointestinal, Anemia, Arterial thromboembolism, Hemorrhage, Cirrhosis of liver, Infusion reaction, Posterior reversible encephalopathy syndrome, Nephrotic syndrome, Proteinuria

Colorectal cancer, metastatic: IV
8 mg/kg every 2 weeks in combination with FOLFIRI (irinotecan, leucovorin, and fluorouracil); continue until disease progression or unacceptable toxicity
Gastric cancer, advanced or metastatic: IV
8 mg/kg every 2 weeks as a single agent or in combination with paclitaxel
Non-small cell lung cancer, metastatic: IV
10 mg/kg on day 1 every 21 days in combination with docetaxel

Safety and efficacy not established in pediatric patients.

There are no dosage adjustments provided in the manufacturer's labeling.

1. Mild (normal bilirubin with AST > ULN or total bilirubin >1 to 1.5 times ULN and any AST) or moderate (total bilirubin >1.5 to 3 times ULN and any AST) impairment: No dosage adjustment necessary.
2. Severe impairment (total bilirubin >3 times ULN and any AST): There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).