Evidence map›Paper›PMID 38698690›Full record

ArticleCancer medicine2024

Assessing patient risk, benefit, and outcomes in drug development: A decade of ramucirumab clinical trials.

Adam Khan, Hassan Khan, Griffin K Hughes, Chase Ladd, Ryan McIntire, Brooke Gardner, Andriana M Peña, Abigail Schoutko, Jordan Tuia, Kirstien Minley and 3 more

Abstract read
In one paragraph

Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Adam KhanOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.ORCID 0000-0003-1358-5119
Hassan KhanOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Griffin K HughesOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Chase LaddOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Ryan McIntireOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.ORCID 0000-0002-1447-3832
Brooke GardnerOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Andriana M PeñaOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Abigail SchoutkoDepartment of Internal Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Jordan TuiaDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
Kirstien MinleyOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Alyson HaslamDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0002-7876-3978
Vinay PrasadDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
Matt VassarOffice of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aims to evaluate published clinical trials of ramucirumab to assess the risk/benefit profile and burden over time for patients.

backgroundThe burden of oncologic drug development on patients paired with increasing clinical trial failure rates emphasizes the need for reform of drug development. Identifying and addressing patterns of excess burden can guide policy, ensure evidence-based protections for trial participants, and improve medical decision-making.

methodsOn May 25, 2023 a literature search was performed on Pubmed/MEDLINE, Embase, Cochrane CENTRAL, and ClinicalTrials.gov for clinical trials using ramucirumab as monotherapy or in combination with other interventions for cancer treatment. Authors screened titles and abstracts for potential inclusion in a masked, duplicate fashion. Following data screening, data was extracted in a masked, duplicate fashion. Trials were classified as positive when meeting their primary endpoint and safety, negative or indeterminate.

resultsRamucirumab was initially approved for gastric cancer but has since been tested in 20 cancers outside of its FDA approved indications. In our analysis of ramucirumab trials, there were a total of 10,936 participants and 10,303 adverse events reported. Gains in overall survival and progression-free survival for patients were 1.5 and 1.2 months, respectively. FDA-approved indications have reported more positive outcomes in comparison to off-label indications.

conclusionWe found that FDA-approved indications for ramucirumab had better efficacy outcomes than non-approved indications. However, a concerning number of adverse events were observed across all trials assessed. Participants in ramucirumab randomized controlled trials saw meager gains in overall survival when evaluated against a comparison group. Clinicians should carefully weigh the risks associated with ramucirumab therapy given its toxicity burden and poor survival gains.

Indexed as

Antibodies, Monoclonal, HumanizedClinical Trials as TopicDrug DevelopmentRamucirumabAntineoplastic AgentsHumansNeoplasmsRisk AssessmentAntibodies, Monoclonal, HumanizedAntineoplastic AgentsRamucirumab

Identifiers

PMID38698690
PMCPMC11066501

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.