What is the role of ziv-aflibercept in the treatment of colon cancer?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Ziv-aflibercept is a fusion protein that acts as a decoy receptor for VEGF-A, VEGF-B, and placental growth factor (PlGF). This agent was approved for use in combination with FOLFIRI for the treatment of patients with metastatic colorectal cancer that is resistant to or has progressed after an oxaliplatin-containing fluoropyrimidine-based regimen. [126]

Approval was based on the Aflibercept Versus Placebo in Metastatic Colorectal Cancer (mCRC) After Failure of an Oxaliplatin-Based Regimen (VELOUR) trial that included 1226 patients. Results showed that when ziv-aflibercept was used in combination with FOLFIRI, overall survival and progression-free survival improved in patients with mCRC previously treated with an oxaliplatin containing regimen. [127]

A phase III trial by Van Cutsem and colleagues in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen found that the addition of ziv-aflibercept fluorouracil, leucovorin, and irinotecan (FOLFIRI) improves survival. Median survival time was 13.5 months with ziv-aflibercept plus FOLFIRI versus 12.06 months with FOLFIRI alone (P = O.0032); PFS was 6.90 versus 4.67 months, respectively (P < 0.0001). [128]


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