{"entity":{"id":"ziv-aflibercept","kind":"drug","name":"Ziv-aflibercept","aka":["Aflibercept (oncology formulation)","VEGF Trap"],"tldr":"Ziv-aflibercept (Zaltrap) is a decoy receptor that soaks up the blood-vessel growth signal VEGF. It is added to the FOLFIRI chemotherapy combination for bowel cancer that has spread and progressed after oxaliplatin.","summary":"Ziv-aflibercept was approved by the FDA in August 2012 with FOLFIRI for metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen, on the VELOUR trial (1,226 patients) in which adding the drug modestly improved overall survival and progression-free survival over FOLFIRI plus placebo, including in patients who had received bevacizumab. The EU authorised Zaltrap in 2013. Its role overlaps with bevacizumab continued beyond progression and with ramucirumab (RAISE), and cost has limited uptake. Haemorrhage, gastrointestinal perforation and compromised wound healing carry boxed warnings; hypertension and proteinuria are common. The same molecule is the ophthalmic drug Eylea.","status":"approved","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Aflibercept","links":[{"label":"US label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=ziv-aflibercept"},{"label":"NCI drug page","url":"https://www.cancer.gov/about-cancer/treatment/drugs/ziv-aflibercept"},{"label":"EPAR","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/zaltrap"},{"label":"NICE TA307 (not recommended)","url":"https://www.nice.org.uk/guidance/ta307"}],"tags":["nci-list"],"related":["bevacizumab","ramucirumab","folfiri"],"cancers":["colorectal"],"sections":[],"technologies":["antiangiogenic"],"targets":["vegf"],"drugs":[],"companies":["sanofi","regeneron"],"institutions":[],"pathways":[],"terms":[],"trials":["velour","nct03172299","nct00390234","nct01882868"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Zaltrap","modality":"Recombinant fusion protein (VEGF ligand trap)","mechanism":"Fusion of VEGFR1 and VEGFR2 extracellular domains with human IgG1 Fc; binds VEGF-A, VEGF-B and placental growth factor with sub-picomolar affinity, preventing receptor activation and angiogenesis.","approvals":[{"region":"US","year":2012,"indication":"Metastatic colorectal cancer resistant to or progressing after oxaliplatin, with FOLFIRI"},{"region":"EU","year":2013,"indication":"Metastatic colorectal cancer resistant to or progressing after oxaliplatin, with FOLFIRI"},{"region":"US","year":2012,"indication":"Metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen, with FOLFIRI","note":"Approved August 2012 on VELOUR."},{"region":"EU","year":2013,"indication":"Metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen, with FOLFIRI","note":"Zaltrap marketing authorisation issued 1 February 2013."},{"region":"England (NICE)","year":2014,"indication":"Not recommended","note":"TA307, published 25 March 2014: aflibercept with irinotecan and fluorouracil-based therapy is not recommended within its marketing authorisation; patients already receiving it could continue."}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/ziv-aflibercept/","neighbours":{"drug":[{"id":"bevacizumab","kind":"drug","name":"Bevacizumab","route":"/drugs/bevacizumab/"},{"id":"folfiri","kind":"drug","name":"FOLFIRI (5-FU, leucovorin, irinotecan)","route":"/drugs/folfiri/"},{"id":"ramucirumab","kind":"drug","name":"Ramucirumab","route":"/drugs/ramucirumab/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"antiangiogenic","kind":"technology","name":"Anti-angiogenic therapy","route":"/technologies/antiangiogenic/"}],"target":[{"id":"vegf","kind":"target","name":"VEGF / VEGFR","route":"/targets/vegf/"}],"company":[{"id":"regeneron","kind":"company","name":"Regeneron","route":"/companies/regeneron/"},{"id":"sanofi","kind":"company","name":"Sanofi","route":"/companies/sanofi/"}],"trial":[{"id":"nct01882868","kind":"trial","name":"A Study of Aflibercept in Combination With FOLFIRI in Patients With Second-Line Metastatic Colorectal Cancer in Japan","route":"/trials/nct01882868/"},{"id":"nct03172299","kind":"trial","name":"Prevention of Neovascular Glaucoma by Intravitreal Injections of Anti-VEGF in Patients Treated with Proton Therapy for a Large Choroidal Melanoma","route":"/trials/nct03172299/"},{"id":"velour","kind":"trial","name":"VELOUR","route":"/trials/velour/"},{"id":"nct00390234","kind":"trial","name":"Ziv-aflibercept in Treating Patients With Locally Advanced, Unresectable, or Metastatic Gynecologic Soft Tissue Sarcoma","route":"/trials/nct00390234/"}],"term":[{"id":"colorectal-uk-drug-access","kind":"term","name":"Colorectal cancer drugs in England: what NICE has recommended","route":"/terms/colorectal-uk-drug-access/"}]}}