title: Efficacy and safety of aflibercept in metastatic colorectal cancer pretreated with bevacizumab: A report of five cases.
abstract: Aflibercept is a recombinant fusion protein that acts by inhibiting tumoural angiogenesis. Efficacy data obtained in the VELOUR randomised study has contributed to the approval of aflibercept as a second-line metastatic colorectal cancer (mCRC) treatment following an oxaliplatin-based regimen. The present study reports a case series of five patients with mCRC, who were treated in two centres since 2011 in the Compassionate Use Program for aflibercept. All patients had aKRASmutation and previously received palliative fluoropyrimidine-oxaliplatin-based chemotherapy with bevacizumab. A doublet with irinotecan combined with aflibercept was administered until progression of disease. The majority of patients received a greater number of aflibercept cycles than the median reported in the VELOUR study (12 vs. 7 cycles), with manageable and reversible toxicity. The most frequent adverse events observed were diarrhoea, neutropenia, fatigue, proteinuria and hypertension. Most cases obtained a progression-free survival greater than the median reported in the VELOUR study (11 vs. 6.9 months) and, in a subgroup of patients previously treated with bevacizumab, and a median survival time of ~47 months was reached from the initial treatment of the disease. The present study contrasts the efficacy and safety results obtained from the pivotal VELOUR trial, and confirms that aflibercept, used in routine clinical practice outside of the clinical trial environment, is active and well-tolerated following bevacizumab treatment.
authors.affiliation: Oncology Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Alcaide
authors.affiliation: Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain.
authors.forename: Mayte
authors.initials: M
authors.lastname: Delgado
authors.affiliation: Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Legerén
authors.affiliation: Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Jurado
authors.affiliation: Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Blancas
authors.affiliation: Pathology Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pereda
authors.affiliation: Pathology Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: López
authors.affiliation: Pharmacy and Nutrition Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Garrido
authors.affiliation: Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Sánchez
authors.affiliation: Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: García
authors.affiliation: Oncology Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rueda
keywords: VEGF; VEGFR; aflibercept; angiogenesis; metastatic colorectal cancer; targeted therapy