Acute hypertension during ramucirumab infusion in two patients with advanced oesophagogastric cancer

BMJ Case Rep. 2016 Aug 18:2016:bcr2016215801. doi: 10.1136/bcr-2016-215801.

Abstract

Ramucirumab, a monoclonal antibody targeting the vascular endothelial growth factor (VEGF) pathway, in combination with paclitaxel is becoming part of standard second-line systemic therapy for advanced oesophagogastric cancer, based on the results of the REGARD and RAINBOW trials. Common well-known side effects of VEGF pathway inhibitors are hypertension and infusion-related reactions. Here, we describe hypertension as the predominant feature of an infusion-related reaction in 2 patients with metastasised oesophagogastric carcinoma treated with ramucirumab and paclitaxel as second-line treatment and propose possible explanations of this side effect previously undescribed for ramucirumab.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Esophageal Neoplasms / drug therapy*
  • Humans
  • Hypertension / chemically induced*
  • Infusions, Intravenous
  • Male
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects*
  • Ramucirumab
  • Stomach Neoplasms / drug therapy*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Paclitaxel