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Ramucirumab is a fully human IgG1 monoclonal antibody that acts as a direct antagonist of vascular endothelial growth factor receptor 2 (VEGFR2). By binding with high affinity to the extracellular domain of VEGFR2, it blocks the binding of natural ligands (VEGF-A, VEGF-C, and VEGF-D), thereby inhibiting ligand-induced activation of the receptor. This results in suppression of endothelial cell proliferation and migration and ultimately inhibits tumor angiogenesis. Ramucirumab was developed by Eli Lilly and is approved for use in multiple solid tumors including advanced or metastatic gastric cancer or gastroesophageal junction adenocarcinoma (as monotherapy or in combination with paclitaxel), metastatic non-small cell lung cancer (in combination with docetaxel), metastatic colorectal cancer (in combination with FOLFIRI), and hepatocellular carcinoma after prior sorafenib therapy[3][4][9]. It has been marketed globally since 2014.
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