SUMMARY:ZALTRAP® (Aflibercept) is a soluble fusion protein that is capable of binding with high affinity to pro-angiogenic factors such as all VEGF-A isoforms, VEGF-B, and PlGF. This is unlike bevacizumab, which is a monoclonal antibody that only targets all isoforms of VEGF-A. VELOUR is a phase III trial in which 1,226 patients who had failed oxaliplatin-based therapy received second-line therapy and the comparison was FOLFIRI (leucovorin, fluorouracil, irinotecan) with or without ZALTRAP® (Aflibercept). With a median follow-up of 22.3 months, there was significant improvement in the progression-free survival noted in the ZALTRAP® (Aflibercept) group (6.9 vs 4.67 months; HR = 0.758;P = .00007) as well as overall survival (13.5 vs 12.06 months; HR = 0.817;P = .0032). This benefit was seen irrespective of prior bevacizumab therapy. The authors did point out that in the E3200 Intergroup trial, which tested second-line FOLFOX4 chemotherapy with or without bevacizumab, all of the patients were bevacizumab-naive, whereas 70% in the VELOUR trial were bevacizumab-naive.Van Cutsem E, Tabernero J, Lakomy R, et al. Results of a multinational phase 3 trial (EFC10262-VELOUR). 13th ESMO World Congress on Gastrointestinal Cancer. Abstract 0-0024.
Tag: Colon Cancer
Oncoprescribe Blog To treat or not to treat Stage II colon cancer? – Molecular Markers to the rescue
As we understand the molecular biology of colon cancer, it is becoming clear that tumors with MisMatch Repair Deficiency (MMR-D) and high MicroSatellite Instability (MSI) tend to have a favorable prognosis and do not benefit from chemotherapy and on the contrary, 5-FU based chemotherapy may potentially result in a detrimental effect. The Oncotype DX colon cancer 12 gene assay is a valuable tool that can provide additional information in the decision making process.
Oncoprescribe Blog Will BRAF trump KRAS testing in Metastatic Colon Cancer?
Testing for KRAS mutations is presently the standard of care prior to treatment with anti EGFR monoclonal antibodies such as cetuximab and panitumumab, as KRAS mutant colorectal tumors do not respond to anti EGFR monoclonal antibodies. However it is becoming clear that BRAF which is involved in intracellular signaling and cell growth and a principal downstream mediator of KRAS, when mutated resulted in shorter progression free survival and overall survival regardless of KRAS status. Targeted therapy may be taking a turn for the better making treatment more personalized.