Efficacy and safety of aflibercept in metastatic colorectal cancer pretreated with bevacizumab: A report of five cases

Alcaide,Julia; Delgado,Mayte; Legerén,Marta; Jurado,José  Miguel; Blancas,Isabel; Pereda,Teresa; López,Jorge; Garrido,Margarita; Sánchez,María  J.; García,José  L.; Rueda,Antonio

doi:10.3892/ol.2016.5068

Efficacy and safety of aflibercept in metastatic colorectal cancer pretreated with bevacizumab: A report of five cases

Authors:
- Julia Alcaide
- Mayte Delgado
- Marta Legerén
- José Miguel Jurado
- Isabel Blancas
- Teresa Pereda
- Jorge López
- Margarita Garrido
- María J. Sánchez
- José L. García
- Antonio Rueda
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Affiliations: Oncology Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain, Oncology Department, San Cecilio Clinical Hospital, Granada, 18014 Andalucía, Spain, Pathology Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain, Pharmacy and Nutrition Department, Costa del Sol Hospital, Marbella, 29603 Málaga, Spain
Published online on: August 30, 2016 https://doi.org/10.3892/ol.2016.5068
Pages: 3127-3134
Copyright: © Alcaide et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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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 a KRAS mutation 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.

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