2 The technology

Description of the technology

Ramucirumab (Cyramza, Eli Lilly and Company) is a fully human immunoglobulin G1 monoclonal antibody. It blocks the vascular endothelial growth factor receptor‑2, which plays an important role in the formation of new blood vessels in tumours.

Marketing authorisation

Ramucirumab in combination with docetaxel for treating locally advanced or metastatic non-small-cell lung cancer in adults with disease progression after platinum-based chemotherapy.

Adverse reactions

The summary of product characteristics includes the following very common adverse reactions: neutropenia, fatigue or asthenia, leukopenia, epistaxis, diarrhoea and stomatitis. For full details of adverse reactions and contraindications, see the summary of product characteristics.

Recommended dose and schedule

It is administered intravenously in a hospital outpatient setting. The recommended dose of ramucirumab is 10 mg/kg on day 1 of a 21‑day cycle, before docetaxel infusion.


Ramucirumab costs £500 per 10‑ml vial (containing 100 mg ramucirumab) and £2,500 per 50‑ml vial (containing 500 mg ramucirumab). The company estimated that the mean cost of ramucirumab was £3,733 per cycle with an average of 6 treatment cycles. The average cost of a course of treatment is estimated to be approximately £22,400. Costs may vary in different settings because of negotiated procurement discounts.

  • National Institute for Health and Care Excellence (NICE)