ramucirumab + pemetrexed + cisplatin

Ramucirumab + pemetrexed + cisplatin is a combination regimen used primarily in the treatment of advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC)[1][3][5][6][7]. - **Ramucirumab** is a fully human monoclonal antibody (IgG1) acting as a vascular endothelial growth factor receptor 2 (VEGFR2) antagonist; it binds to the extracellular domain of VEGFR2, preventing activation by VEGF ligands, and thus inhibits tumor angiogenesis[2][3]. - **Pemetrexed** is an antifolate small molecule that inhibits several folate-dependent enzymes involved in the synthesis of DNA and RNA, blocking tumor cell proliferation[3][4]. - **Cisplatin** is a platinum-based chemotherapeutic that forms DNA crosslinks, leading to apoptosis of cancer cells[3]. The combination regimen was evaluated in a phase II clinical trial in previously untreated stage IV nonsquamous NSCLC, aiming to improve progression-free survival and clinical outcomes[1][3][5][6][7]. Evidence shows increased disease control and clinical activity, but did not meet the endpoint of significant prolongation of progression-free survival[3][6]. Ramucirumab is developed by Lilly[2], pemetrexed by Eli Lilly[4], and cisplatin was originally developed by Bristol Myers Squibb.