Role of the VEGF Inhibitor Aflibercept in mCRC

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The VELOUR study evaluated the VEGF inhibitor aflibercept as second-line therapy in patients with metastatic colorectal cancer (mCRC). In the study, patients with mCRC who experienced disease progression after oxaliplatin-based therapy were randomized to FOLFIRI plus aflibercept or FOLFIRI plus placebo. The results demonstrated that overall survival (OS) was improved by 1.4 months in the aflibercept group compared with placebo. The median OS was 13.50 months with aflibercept versus 12.06 months with placebo. Subgroup analysis showed an OS benefit with aflibercept, regardless of prior exposure to first-line bevacizumab, states Johanna Bendell, MD.

Alan P. Venook, MD, states that he would like to see additional study results to learn more about aflibercept before he administers the drug. Heinz-Josef Lenz, MD, continues to use bevacizumab, based on a perceived toxicity advantage compared with aflibercept.

Marwan Fakih, MD, comments that the treatment of mCRC is more of an art than an algorithm, and that the development of new drugs provides clinicians with more options. He notes that his treatment plans vary widely and are based on a patient’s prior therapy, age, and treatment goals. He suggests that the patient population that would benefit most from aflibercept has yet to be identified.