Multicenter phase 2 study of second-line gemcitabine with or without ramucirumab for malignant pleural mesothelioma

There is preclinical rationale for inhibiting angiogenesis in malignant pleural mesothelioma (MPM). The multicenter randomized phase 2 RAMES trial in Italy evaluated gemcitabine with or without the anti-VEGFR-2 antibody ramucirumab as second line treatment for MPM. The median overall survival was 13.8 months with gemcitabine-ramucirumab versus 7.5 months with gemcitabine-placebo (HR 0.71; p=0.028). The authors conclude that addition of ramucirumab to second-line gemcitabine significantly improved OS after first-line standard chemotherapy for MPM. The safety profile of the combination was favorable.