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NCCN Guidelines for Patients


Stomach Cancer, Version 1.2016

Figure 14.

VEGF targeted therapy

Cancer cells need blood to grow.

They send VEGF to endothelial

cells to start the growth of blood

vessels. Ramucirumab blocks

VEGF from attaching to receptors.

endothelial cell




Overview of cancer treatments Targeted therapy

Targeted therapy

Targeted therapy is a class of drugs that stops the

action of molecules that help cancer cells grow. It is

less likely to harm normal cells than chemotherapy.

Targeted therapy for stomach cancer targets either









actor) or HER2.

These treatments are briefly described next. Some

side effects are listed. Ask your treatment team for

a full list of common and rare side effects. In Part 5,

information on who should receive these drugs is


VEGF pathway

Cancer cells need the food and oxygen in blood to

grow. Cancer cells get blood from blood vessels

that have grown into the tumor. VEGF is one of the

molecules that triggers the growth of these blood


VEGF is made by cancer cells. It travels from cancer

cells to endothelial cells, which form blood vessels.

VEGF attaches to surface receptors on the outside

of endothelial cells. Surface receptors are proteins

within cell membranes that extend from the inside to

the outside of cells. Attachment of VEGF to receptors

triggers growth signals. Ramucirumab is a medicine

that targets VEGF.


Ramucirumab attaches to VEGF receptors on the

outside of endothelial cells.

See Figure 14

. This

blocks VEGF from attaching. No growth signals

caused by VEGF are started.

Ramucirumab is given by infusion. It takes 60 minutes

to receive the full dose. Ramucirumab is always given

with chemotherapy. It is given every two weeks on the

first day of chemotherapy.

Common side effects of ramucirumab are high blood

pressure and diarrhea. Serious side effects include

bleeding; blood clots; holes in the gut; abnormal

passage between body parts; and slow wound


Copyright © 2016 National Comprehensive Cancer Network® (NCCN®).