II. Indications

  1. Colorectal Cancer (metastatic, refractory)

III. Mechanism

  1. Recombinant fusion Protein that acts as a decoy for Vascular Endothelial Growth Factor (VEGF) receptors
    1. Competitive inhibitor of VEGF receptor binding (VEGF-A and VEGF-B)
    2. Blocks the VEGF Angiogenesis signaling pathway of tumor cells
  2. Fusion Protein has two components
    1. VEGF Receptor Epitopes (surface protein Antigens)
    2. Constant region (Fc) of human IgG1
  3. Ziv-Aflibercept also blocks placental growth factor

IV. Medications

  1. Ziv-Aflibercept (Zaltrap)
    1. Dosed IV, unlike other VEGF Inhibitors and small molecule agents

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters, pregnancy category X)
    1. Use reliable Contraception

VII. Adverse Effects

  1. Cardiovascular
    1. Severe Hypertension (including PRES)
    2. Arterial Thrombotic Events
  2. Hematologic
    1. Neutropenia
    2. Hemorrhage (esp. Gastrointestinal)
  3. Gastrointestinal
    1. Gastrointestinal fistula or perforation
    2. Severe Diarrhea
    3. Transaminase increase
    4. Abdominal Pain
    5. Decreased appetite
  4. Dermatologic
    1. Impaired Wound Healing
  5. Renal
    1. Proteinuria
    2. Acute Kidney Injury
  6. Neurologic
    1. Headache

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Ontology: ziv-aflibercept (C3485619)

Definition (NCI) A recombinant protein comprised of epitopes of the extracellular domains of human vascular endothelial growth factor receptors (VEGFR) fused to the constant region (Fc) of human IgG1 with potential antiangiogenic activity. Afilbercept, functioning as a soluble decoy receptor, binds to pro-angiogenic vascular endothelial growth factors (VEGFs), thereby preventing VEGFs from binding to their endogenous receptors. Disruption of the binding of VEGFs to their cellular receptors may result in the inhibition of tumor angiogenesis, metastasis, and ultimately tumor regression.
Definition (NCI_NCI-GLOSS) A substance being studied in the treatment of several types of cancer. Vascular endothelial growth factor trap blocks the action of vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels that tumors need to grow. It is a type of antiangiogenesis agent.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C533178
English ZIV-AFLIBERCEPT, ziv-aflibercept, Ziv-Aflibercept, ZIV-aflibercept, ziv-aflibercept (medication), chemotherapeutics ziv-aflibercept