Ramucirumab in addition to erlotinib for EGFR mutation-positive metastatic non-small-cell lung cancer

Ramucirumab in addition to erlotinib is in clinical development for Epithelial Growth Factor Receptor (EGFR) mutation-positive metastatic Non-Small-Cell Lung Cancer (NSCLC). NSCLC makes up the majority of lung cancers in the UK. Stage IV (advanced/metastatic) NSCLC is when the cancer has spread beyond the lung which was initially affected, most often to the liver, the adrenal glands, the bones, and the brain. Certain genetic mutations to the EGFR are known to play critical role in NSCLC progression and response to treatment due to the fact that overexpression of EGFR is known to accelerate the growth of cancer cells.
Ramucirumab has been designed to attach to a receptor for a protein called Vascular Endothelial Growth Factor (VEGF). The VEGF receptor can be present at high levels in tumours and helps in the development of new blood vessels that supply the tumours. Ramucirumab blocks this action by blocking this receptor, thereby reducing the blood supply to the tumour and slowing the growth of the cancer. Erlotinib is currently a standard of care first-line treatment for locally advanced or metastatic NSCLC with EGFR mutations. It is thought that the addition of ramucirumab to erlotinib might improve its efficacy and provide an additional benefit by delaying/suppressing the EGFR mutation in patients with NSCLC.