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

Images: Related links to external sites (from Bing)

Related Studies