Dr. Tabernero on Sequencing Angiogenesis Inhibitors in mCRC

Josep Tabernero, MD, PhD, head, Medical Oncology Department, Vall d’Hebron University Hospital, director, Vall d’Hebron Institute of Oncology, discusses his opinions on which patients with metastatic colorectal cancer should receive ziv-aflibercept following bevacizumab.

Tabernero says the right answer to this is still unknown. In the VELOUR trial, only one-third of the patients had previously received bevacizumab, which means researchers only have a small population of patients to draw conclusions from.

Taking this into consideration, Tabernero says the data looks good for patients who received prior bevacizumab and also for patients who continue bevacizumab, according to the TML trial. However, the population from the TML trial is not completely comparable to the population in the VELOUR trial, Tabernero warns, and he suggests having a head-to-head comparison.

Since PFS and OS are hard to compare, Tabernero suggests comparing the response rates of the two trials. In the VELOUR trial, the combination of aflibercept and FOLFIRI had a better response rate than FOLFIRI alone. The increase of response rate that was seen in the VELOUR trial was greater than the increase in the response rate that was seen in the TML trial.

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