Adverse reaction profile for CYRAMZA in combination with docetaxel¹

ADVERSE REACTIONS OCCURRING WITH CYRAMZA PLUS DOCETAXEL AT INCIDENCE RATE ≥5% AND ≥2% HIGHER THAN WITH PLACEBO PLUS DOCETAXEL1

ADR chart

MedDRA=Medical Dictionary for Regulatory Activities.

  • 31% of patients (195 out of 627) in the REVEL trial received CYRAMZA for at least 6 months1 Median duration of exposure was 3.5 months (median of 4.5 doses)
  • Discontinuation of CYRAMZA/placebo due to ≥1 treatment emergent adverse event was 1.4% (n=9) in the CYRAMZA plus docetaxel arm vs 1% (n=6) in the placebo plus docetaxel arm. Discontinuation of docetaxel due to ≥1 treatment adverse event was 7.8% (n=49) vs 4.2% (n=26)2 - Treatment discontinuation due to adverse reactions occurred more frequently in CYRAMZA plus docetaxel-treated patients (9%) than in placebo plus docetaxel-treated patients (5%)
  • The median relative dose intensity was 98.0% for CYRAMZA and 98.7% for placebo. The median relative dose intensity of docetaxel was 93.5% for the CYRAMZA plus docetaxel arm and 96.5% for placebo plus docetaxel arm3
  • 51% (n=320/628) of patients received ≥1 subsequent therapy post-discontinuation with CYRAMZA plus docetaxel vs 55% (n=343/625) of patients for placebo plus docetaxel4

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  • The most common serious adverse events with CYRAMZA plus docetaxel were febrile neutropenia (14%), pneumonia (6%), and neutropenia (5%). The use of granulocyte colony-stimulating factors was 42% in CYRAMZA plus docetaxel-treated patients versus 37% in patients who received placebo plus docetaxel.
  • In patients ≥65 years of age, there were 18 (8%) deaths on treatment or within 30 days of discontinuation for CYRAMZA plus docetaxel and 9 (4%) deaths for placebo plus docetaxel. In patients <65 years of age, there were 13 (3%) deaths on treatment or within 30 days of discontinuation for CYRAMZA plus docetaxel and 26 (6%) deaths for placebo plus docetaxel.
  • Treatment discontinuation due to adverse reactions occurred more frequently in CYRAMZA plus docetaxel-treated patients (9%) than in placebo plus docetaxel-treated patients (5%). The most common adverse events leading to treatment discontinuation of CYRAMZA were infusion-related reaction (0.5%) and epistaxis (0.3%).
  • For patients with nonsquamous histology, the overall incidence of pulmonary hemorrhage was 7% and the incidence of grade ≥3 pulmonary hemorrhage was 1% for CYRAMZA plus docetaxel compared to 6% overall incidence and 1% for grade ≥3 pulmonary hemorrhage for placebo plus docetaxel. For patients with squamous histology, the overall incidence of pulmonary hemorrhage was 10% and the incidence of grade ≥3 pulmonary hemorrhage was 2% for CYRAMZA plus docetaxel compared to 12% overall incidence and 2% for grade ≥3 pulmonary hemorrhage for placebo plus docetaxel.
  • Clinically relevant adverse reactions reported in ≥1% and <5% of CYRAMZA plus docetaxel-treated patients in study 3 were hyponatremia (4.8% CYRAMZA plus docetaxel versus 2.4% for placebo plus docetaxel) and proteinuria (3.3% CYRAMZA plus docetaxel versus 0.8% placebo plus docetaxel).
References:
  1. CYRAMZA (ramucirumab) [package insert]. India, Eli Lilly & Company (India) Pvt. Ltd.
  2. Data on file, Eli Lilly and Company. ONC20150915a.
  3. Data on file, Eli Lilly and Company. ONC20150915b.
  4. Supplement to: Garon EB, Ciuleanu T-E, Arrieta O, et al. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): a multicentre, double-blind, randomised phase 3 trial. Lancet. 2014;384(9944):665-673.
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