Ziv-aflibercept
Ziv-aflibercept (Zaltrap) is a decoy receptor that soaks up the blood-vessel growth signal VEGF. It is added to the FOLFIRI chemotherapy combination for bowel cancer that has spread and progressed after oxaliplatin.
Overview
Ziv-aflibercept was approved by the FDA in August 2012 with FOLFIRI for metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen, on the VELOUR trial (1,226 patients) in which adding the drug modestly improved overall survival and progression-free survival over FOLFIRI plus placebo, including in patients who had received bevacizumab. The EU authorised Zaltrap in 2013. Its role overlaps with bevacizumab continued beyond progression and with ramucirumab (RAISE), and cost has limited uptake. Haemorrhage, gastrointestinal perforation and compromised wound healing carry boxed warnings; hypertension and proteinuria are common. The same molecule is the ophthalmic drug Eylea.
- AmivantamabApproved
- CamizestrantApproved
- Comprehensive genomic profilingStandard of care
- Liquid biopsy (ctDNA)Standard of care
- LorlatinibApproved
- MRD / molecular residual disease testingEstablished
- ADC payload neutralisersPhase 1
- BGB-16673Phase 3
- Bispecific ADCPhase 3
- BRUIN CLL-321Positive
- CaDAnCe-304Recruiting
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- A clone report from blood at every treatment cycle
- A fast route to the matched drug when it is licensed for another cancer
- A multi-cancer platform trial of adaptive (dose-holiday) therapy
- A national rapid research autopsy network for end-stage cancer
- A standard evolvability score for every tumour
- A standing platform trial that assigns treatment by how the tumour escaped
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance atlas: how tumours escape and what closes the route · Lines of therapy.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2012 | Metastatic colorectal cancer resistant to or progressing after oxaliplatin, with FOLFIRI |
| EU | 2013 | Metastatic colorectal cancer resistant to or progressing after oxaliplatin, with FOLFIRI |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Ziv-aflibercept" OR ABSTRACT:"Ziv-aflibercept" OR TITLE:"Zaltrap" OR ABSTRACT:"Zaltrap" OR TITLE:"Aflibercept oncology formulation" OR ABSTRACT:"Aflibercept oncology formulation" OR TITLE:"VEGF Trap" OR ABSTRACT:"VEGF Trap") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ziv-aflibercept, not a curated reading list.
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