Potentials for the use of aflibercept in the treatment of patients with metastatic colorectal cancer


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Resumo

Background. Aflibercept is a recombinant protein for several growth factors that binds VEGFA and B, as well as PlGF, determining its antiangiogenic effect. Objective. Clinical evaluation of the efficacy and safety of aflibercept in patients with metastatic colorectal cancer (mCRC). Methods. The data on the treatment of 50 patients with initially metastatic and generalized CRC were analyzed. The study included patients in satisfactory general condition (ECOG <2), after progression on oxaliplatin-containing chemotherapy; in the case of generalization of the process, the time to progression was at least 6 months after completion of the adjuvant treatment. The drug was administered intravenously at a dose of 4 mg/kg once every 14 days in combination with the FOLFIRI regimen. The direct clinical effect, overall and progression-free survival, and adverse events associated with antitumor therapy were evaluated. Results. The objective effect on the background of the therapy was 16.7%, tumor control was achieved in 70.9% of cases. When aflibercept was prescribed as the 2nd-line therapy, a more frequent registration of the objective effect was noted than with its use as the 3rd and subsequent lines. The median time to disease progression was 6.3 (2-18) months, and the median overall survival - 17.1 months (2-48) months. Arterial hypertension was the most common adverse event, which caused the cancellation of aflibercept in 14% of cases. Conclusion. The obtained objective effect and relapse-free survival with the use of aflibercept in patients with CRC were comparable with the data of previous studies, while the earlier drug prescribing, the higher the percentage of objective responses to treatment. Data on overall survival exceeded the results of a registration study for the general patient population. This is probably due to the fact that the study group did not include patients with adverse prognostic factors such as low functional status and progression after adjuvant treatment for 6 months. Of the clinically significant manifestations of toxicity, arterial hypertension should be noted. A personalized approach to the selection of patients for therapy with aflibercept, taking into account risk factors for the development of 3-4 degree non-hematological adverse events, is likely to reduce the number of complications without loss of effectiveness.

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Sobre autores

L. Vladimirova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

Nataliya Abramova

National Medical Research Centre for Oncology

Email: pylulkin@mail.ru
Cand. Sci. (Med.), Senior Researcher at the Department of Antitumor Drug Treatment 63, 14 line, Rostov-on-Don 344037, Russian Federation

I. Popova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

A. Storozhakova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

K. Novoselova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

N. Tikhanovskaya

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

L. Ryadinskaya

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

A. Lyanova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

V. Myagkova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

M. Teplyakova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

S. Kabanov

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

E. Kalabanova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

N. Samaneva

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

A. Tishina

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

L. Strakhova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

M. Yezhova

National Medical Research Centre for Oncology

Rostov-on-Don, Russia

Bibliografia

  1. Chiron M., Bagley R.G., Pollard J, et al. Differential antitumor activity of aflibercept and bevacizumab in patient-derived xenograft models of colorectal cancer. Mol Cancer Ther. 2014;13(6):1636-44. Do: 10.1158/1535-7163.MCT-13-0753.
  2. Van Cutsem E., Tabernero J., Lakomy R., et al. Addition of aflibercept to fluorouracil, leucovorin, and irinotecan improves survival in a phase III randomized trial in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen. J Clin Oncol. 2012;30(28):3499-506. doi: 10.1200/JCO.2012.42.8201.
  3. Федянин М.Ю., Владимирова Л.Ю., Чубенко В.А. и др. Оценка токсичности и эффективности Vladimirova L.Yu., Abramova N.A. - study concept and design. Abramova N.A., Popova I.L., Tikhanovskaya N.M.,терапии комбинацией FOLFIRI и афлиберцепта при метастатическом раке толстой кишки в РФ: первые результаты многоцентрового ретроспективного исследования. Злокачественные опухоли Российское общество клинической онкологии. 2019;9(2):53-63.
  4. Pastorino A., Di Bartolomeo M., Maiello E., et al. Aflibercept Plus FOLFIRI in the Real-life Setting: Safety and Quality of Life Data From the Italian Patient Cohort of the Aflibercept Safety and Quality-of-Life Program Study. Clin Colorectal Cancer. 2018;17(3):e457-e470. Doi: 10.1016/j. clcc.2018.03.002.
  5. Montes A.F., Lago N.M., Rua M.C., et al. Efficacy and safety of FOLFIRI/aflibercept in second-line treatment of metastatic colorectal cancer in a real-world population: Prognostic and predictive markers. Cancer Medicine. 2019;8(3):882-89. doi: 10.1002/cam4.1903.
  6. Hofheinz R, Thaler J, Von Moos R, et al. Quality of life (QoL) and therapy management in metastatic colorectal cancer (mCRC) patients treated with FOLFIRI and aflibercept in Germany, Switzerland, and Austria (GSA): Interim results of the noninterventional QoLiTrap-study. J Clin Oncol. 2016;34(4_suppl):681-81. Doi: 10.1093/ annonc/mdz156.025.
  7. Hofheinz R.D, Derigs H., Piringer G, et al. Interim analysis of the non-interventional study QoLiTrap (AIO-LQ-0113) in patients with metastatic colorectal cancer (mCRC) treated with aflibercept (AFL) + FOLFIRI: Efficacy according to age group 565 and >65 years. Ann Oncol. 2018;29(suppl_8). doi: 10.1093/annonc/ mdy281.121.
  8. Ivanova J.I., Saverno K.R., Sung J, et al. Real-world treatment patterns and effectiveness among patients with metastatic colorectal cancer treated with ziv-aflibercept in community oncology practices in the USA. Med Oncol. 2017;34 (12):193. doi: 10.1007/s12032-017-1049-4.

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