Aflibercept (Zaltrap(®) : aflibercept is a recombinant fusion protein, anti-angiogenic, which blocks activation of VEGF and PIGF receptor), obtained its European approval February 2(nd), 2013 in combination with Folinic Acid, 5FU and irinotecan (FOLFIRI) in adults with metastatic colorectal cancer that is resistant to or has progressed after an oxaliplatin containing regimen. This decision was based on the efficacy and safety results of the VELOUR Phase III trial. This study showed an improved overall survival, with the combination of aflibercept and FOLFIRI versus FOLFIRI + placebo (13.5 months vs 12.06 months ; HR = 0,817, IC à 95 %, 0,714 à 0,935 ; p = 0,003 2). Adverse effects reported with aflibercept combined with FOLFIRI included the specific anti-vascular endothelial growth factor effects and also reflected an increased incidence of some chemotherapy-related toxicities. Aflibercept is the second anti-angiogenic agent after bevacizumab with a FDA and a EMEA approval for patients with metastatic colorectal cancer.
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