Ziv-aflibercept (Zaltrap) for the treatment of metastatic colorectal cancer.
Title | Ziv-aflibercept (Zaltrap) for the treatment of metastatic colorectal cancer. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Perkins SL, Cole SW |
Journal | Ann Pharmacother |
Volume | 48 |
Issue | 1 |
Pagination | 93-8 |
Date Published | 2014 Jan |
ISSN | 1542-6270 |
Keywords | Antineoplastic Agents, Colorectal Neoplasms, Humans, Receptors, Vascular Endothelial Growth Factor, Recombinant Fusion Proteins |
Abstract | OBJECTIVE: Review pharmacology, pharmacokinetics, efficacy, and safety of ziv-aflibercept in combination with FOLFIRI for treatment of metastatic colorectal cancer (mCRC) resistant to or progressed following oxaliplatin-containing regimens. DATA SOURCES: Articles indexed in PubMed (1948-August 2013), TOXLINE (2001-August 2013), and Google Scholar as well as meeting abstracts were identified using the search terms ziv-aflibercept and colorectal cancer. STUDY SELECTION AND DATA EXTRACTION: Available English-language articles DATA SYNTHESIS: Ziv-aflibercept, a selective vascular endothelial growth factor antagonist, was evaluated as monotherapy for treatment of mCRC in a phase 2 study and added to FOLFIRI in a phase 3 trial. Patient response to ziv-aflibercept as monotherapy did not reach statistical significance. Results suggest that response to ziv-aflibercept treatment is not influenced by prior bevacizumab therapy. A phase 3 trial compared the safety and efficacy of ziv-aflibercept plus FOLFIRI with placebo plus FOLFIRI in patients with mCRC who experienced disease progression on an oxaliplatin-containing regimen. Patients in the ziv-aflibercept arm had a median overall survival of 13.5 months, versus 12.06 months for those receiving placebo (hazard ratio [HR] = 0.817, 95% CI = 0.713 to 0.937). Progression-free survival for patients receiving ziv-aflibercept was higher compared with placebo (HR = 0.758; 95% CI = 0.661 to 0.869). The most common adverse effects observed were anemia, diarrhea, and neutropenia. CONCLUSIONS: Ziv-aflibercept is a safe and effective option in combination with FOLFIRI for the treatment of mCRC in patients who progress on oxaliplatin-containing therapy. Superiority over other antiangiogenic treatment has not been established. |
DOI | 10.1177/1060028013506562 |
Alternate Journal | Ann Pharmacother |
PubMed ID | 24259608 |