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Ramucirumab + S-1 + oxaliplatin (RAM+SOX) is an investigational combination therapy developed for the treatment of advanced gastric cancer and gastroesophageal junction adenocarcinoma. The regimen combines ramucirumab (Cyramza), a fully human IgG1 monoclonal antibody that targets the vascular endothelial growth factor receptor 2 (VEGFR-2) to inhibit tumor angiogenesis, with the chemotherapy regimen SOX, which consists of S-1 (an oral fluoropyrimidine) and oxaliplatin (a platinum-based cytotoxic agent). This triple combination was primarily evaluated in the Phase 2 RAINSTORM trial involving East Asian patients. However, the addition of ramucirumab to the standard SOX regimen did not demonstrate a significant improvement in progression-free survival or overall survival compared to SOX plus placebo, leading to the termination of its development for this specific first-line indication.
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