cyramza 500

Cyramza is an anticancer medicine that contains the active substance Ramucirumab. It is a targeted therapy belonging to a class of drugs called “monoclonal antibodies.” It is supplied as a sterile, preservative-free, clear to slightly opalescent, colorless to slightly yellow solution in a single-dose vial.

2. Mechanism of Action:
Cyramza works by inhibiting tumor angiogenesis (the growth of new blood vessels that tumors need to grow and spread). It is a vascular endothelial growth factor receptor 2 (VEGFR2) antagonist. Specifically, it binds to VEGFR2, blocking it from interacting with its ligands (VEGF-A, VEGF-C, and VEGF-D). By blocking this interaction, Cyramza prevents the formation of new blood vessels, thereby cutting off the supply of oxygen and nutrients to the tumor, which slows or stops its growth.

3. Therapeutic Indications (Uses):
Cyramza is used for the treatment of several types of cancer in adults, often in combination with other therapies or alone. Common indications include:

• Gastric Cancer (Stomach Cancer) / Gastroesophageal Junction (GEJ) Adenocarcinoma: Used as a single agent or in combination with paclitaxel chemotherapy for the treatment of advanced or metastatic gastric or GEJ cancer that has progressed after prior chemotherapy.

• Non-Small Cell Lung Cancer (NSCLC): In combination with erlotinib for the first-line treatment of metastatic NSCLC with epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) mutations.

• Colorectal Cancer (CRC): In combination with FOLFIRI chemotherapy for the treatment of metastatic colorectal cancer that has progressed during or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine.

• Hepatocellular Carcinoma (HCC – Liver Cancer): Used as a single agent for the treatment of patients with advanced hepatocellular carcinoma who have elevated alpha-fetoprotein (AFP) and have been previously treated with sorafenib.

4. Warnings and Precautions:
Cyramza can cause serious and sometimes fatal side effects. Close monitoring by your healthcare team is essential.

• Hemorrhage (Bleeding): Cyramza significantly increases the risk of severe and sometimes fatal bleeding, including gastrointestinal bleeding, hemoptysis (coughing up blood), and intracranial hemorrhage. Patients should be monitored for signs and symptoms of bleeding.

• Gastrointestinal Perforation: This drug can increase the risk of developing a hole in the stomach or intestines, which can be fatal.

• Impaired Wound Healing: Cyramza can impair wound healing. Treatment should be withheld before scheduled surgery and not resumed until adequate wound healing has occurred.

• Arterial Thromboembolic Events: Serious and sometimes fatal events such as heart attack, stroke, or transient ischemic attack (TIA) have been reported. Cyramza should be permanently discontinued in patients who experience these events.

• Hypertension (High Blood Pressure): Cyramza can cause severe increases in blood pressure. Blood pressure should be monitored regularly and treated as needed. In cases of severe hypertension not controlled by medication, treatment should be temporarily withheld.

• Infusion-Related Reactions: Severe reactions, including bronchospasm, hypotension, and anaphylactic reactions, can occur during or after the infusion. Premedication is recommended, and patients should be monitored closely.

• Reversible Posterior Leukoencephalopathy Syndrome (RPLS): A rare neurological disorder characterized by headache, seizure, confusion, and visual disturbances has been reported. If RPLS occurs, treatment should be discontinued.

• Thyroid Dysfunction: Cyramza can cause hypothyroidism (underactive thyroid). Thyroid function should be monitored.

• Proteinuria (Protein in Urine): Cyramza can cause protein in the urine, which may indicate kidney damage. Urine protein levels should be monitored.

• Pregnancy and Contraception: Cyramza can cause fetal harm. Women of childbearing potential must use effective contraception during treatment and for at least 3 months after the last dose. Do not breastfeed while taking this medication.

5. Administration:
Cyramza must be prepared and administered by a healthcare professional. It is given as an intravenous (IV) infusion. The dose and frequency depend on the type of cancer being treated, but it is typically administered every 2 or 3 weeks. Premedication with intravenous antihistamines is recommended before each infusion.

6. Storage:
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Keep the vial in the outer carton to protect from light. Do not shake.