Can Ramucirumab cause major bleeding?

Ramucirumab increases the risk of bleeding and gastrointestinal bleeding, including grade ≥3 bleeding events. In 6 clinical studies, the incidence of bleeding of all degrees in 2137 patients with various cancers treated with ramucirumab was 13-55%, and the incidence of grade 3-5 bleeding was 2-5%. Patients who develop severe bleeding (Grade 3 or 4) should permanently discontinue ramucirumab.

Patients with gastric cancer who received nonsteroidal anti-inflammatory drugs (NSAIDs) were excluded from the review and RAINBOW studies. Therefore, the risk of gastric bleeding in patients with gastric cancer who received NSAIDs after treatment with ramucirumab is unknown. Patients with non-small cell lung cancer who were receiving anticoagulant therapy or who had evidence of tumor invasion of major airways were excluded from the REVEL study. NSCLC patients with a history of massive hemoptysis, chronic patients receiving NSAIDs or other antiplatelet therapies (other than once-daily aspirin), or NSCLC patients with imaging evidence of major vascular invasion or intratumoral cavitation were excluded from both the REVEL and RELAY studies. The risk of pulmonary hemorrhage in these patient groups is unknown.

Ramosizumab is usually an injection preparation. The original drug has been on the market in China, but it has been on the market for a short time and has not been included in the medical insurance. The price of 100mg/10mL per box may be around RMB 5,000, and the price of 500mg/50mL per box may be around RMB 17,000. The price of the original Hong Kong version of 100mg/10mL may be around RMB 8,400 per box, and the price of 500mg/50mL per box may be around RMB 28,000 (the price may fluctuate due to exchange rates), and their pharmaceutical ingredients are basically the same. Currently, there are no generic drugs produced and marketed overseas. For specific prices and drug information, please consult Yaode’s medical consultant.