Ramucirumab (Cyramza) for women with metastatic bowel cancer

In 2016, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of ramucirumab in people with metastatic bowel cancer. The drug manufacturer provided IQWiG with one relevant study involving 457 women. About half of them were given ramucirumab and FOLFIRI, while the other half had treatment with FOLFIRI only.

What are the advantages of ramucirumab?

  • Life expectancy: the study suggests a benefit from the use of ramucirumab: Half of the women who used ramucirumab and FOLFIRI had passed away within about 13 months, whereas this was the case within 11 months in the comparison group.

What are the disadvantages of ramucirumab?

  • Severe side effects: There was weak evidence of a disadvantage in terms of severe side effects. 79 out of 100 participants who received ramucirumab and FOLFIRI had severe side effects, compared with 62 out of 100 who only receibed FOLFIRI.
  • Treatment stopped due to side effects: Here too, there was weak evidence for a disadvantage. 29 out of 100 women stopped treatment with ramucirumab and FOLFIRI due to side effects, while in the comparison group 13 out of 100 did the same.
  • Bleeding, headaches, hand-foot syndrome and edema: There was weak evidence of a disadvantage for ramucirumab and FOLFIRI regardinng these side effects. Edema, for instance, was reported in 20 out of 100 women who had treatment with ramucirumab and FOLFIRI. In the comparison group, 9 out of 100 women developed edema.

No difference

  • Fatigue: No difference was found. About 65 to 74 out of 100 women developed fatigue.
  • Loss of appetite and constipation: There was no difference. About 46 to 57 out of 100 women developed these symptoms.
  • Diarrhea, shortness of breath, insomnia, nausea and vomiting: In both groups, about 42 to 54 out of 100 women developed these symptoms, with no discernible differences between the groups.
  • Overall health and quality of life: There was no difference here. This is alaso true for subcategories of quality of life such as physical, emotional or social functioning.