ramucirumab + mitoxantrone + prednisone

**ramucirumab + mitoxantrone + prednisone** is an investigational drug combination evaluated for treatment of metastatic castration-resistant prostate cancer (mCRPC) in patients who progressed after docetaxel therapy. Ramucirumab is a recombinant human monoclonal antibody targeting vascular endothelial growth factor receptor-2 (VEGFR-2), thereby inhibiting angiogenesis. Mitoxantrone is an anthracenedione, a cytotoxic small molecule agent inhibiting topoisomerase II, leading to DNA damage and apoptosis. Prednisone is a synthetic glucocorticoid that exerts anti-inflammatory and immunosuppressive effects, used to reduce inflammation and mitigate adverse effects of chemotherapy. The regimen was studied in a randomized phase II trial, showing feasible safety and moderate efficacy for docetaxel-pretreated men with mCRPC; median overall survival was 13.0 months for the ramucirumab arm, with a median progression-free survival of 6.7 months[1][3].