Aflibercept in the treatment of patients with metastatic colorectal cancer: latest findings and interpretations.

Inhibition of angiogenesis is an established adjunct in the treatment of metastatic colorectal cancer. Bevacizumab, a monoclonal antibody that binds to vascular endothelial growth factor (VEGF) A, improves clinical outcomes when added to standard chemotherapy for metastatic colorectal cancer. Unfortunately, the development of resistance is inevitable, and novel therapeutic strategies are needed. Aflibercept is an intravenously administered fusion protein of the human vascular endothelial growth factor receptor 1 (VEGFR1) and VEGFR2 extracellular domains. This antiangiogenic agent binds to VEGF A, VEGF B, and placental growth factor 1 (PlGF1) and PlGF2 with high affinity and inhibits downstream signaling. Common side effects of single agent aflibercept are similar to other antiangiogenic drugs and include hypertension, proteinuria, fatigue, and headache. Recent clinical data regarding the efficacy of aflibercept with standard chemotherapy for metastatic colorectal cancer, associated adverse events, and future areas of research are reviewed.