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Pembrolizumab + ramucirumab is a combination of two monoclonal antibody therapies used in oncology clinical trials. Pembrolizumab is a humanized IgG4-kappa monoclonal antibody that targets programmed cell death protein 1 (PD-1), blocking its interaction with PD-L1 and PD-L2, thereby enhancing T-cell mediated immune responses against tumors. Ramucirumab is a fully human IgG1 monoclonal antibody that binds to vascular endothelial growth factor receptor 2 (VEGFR2), inhibiting the binding of VEGF ligands and thus blocking angiogenesis, which tumors require for growth and metastasis. The combination aims to synergistically enhance antitumor activity by both promoting immune-mediated tumor destruction (via checkpoint inhibition) and disrupting tumor blood supply (via antiangiogenic effects). This regimen has been studied in advanced cancers such as non-small cell lung cancer, head and neck squamous cell carcinoma, gastric/gastroesophageal junction adenocarcinoma, urothelial carcinoma, and biliary tract cancer[2][3][4][5].
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