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Ziv-aflibercept
Source: Colon Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: February 12, 2025 · Captured 2026-09-09.
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Ziv-aflibercept is an anti-VEGF molecule and has been evaluated as a component of second-line therapy in patients with metastatic colorectal cancer.
Evidence (ziv-aflibercept):
In one trial, 1,226 patients were randomly assigned to receive ziv-aflibercept (4 mg/kg intravenously [IV]) or placebo every 2 weeks in combination with FOLFIRI.[81][Level of evidence A2]
Source links and citations
In one trial, 1,226 patients were randomly assigned to receive ziv-aflibercept (4 mg/kg intravenously [IV]) or placebo every 2 weeks in combination with FOLFIRI.[81][Level of evidence A2]
Patients who received ziv-aflibercept/FOLFIRI had significantly improved OS rates, with median survival times of 13.50 months compared with patients who received placebo/FOLFIRI, with median survival times of 12.06 months (HR, 0.817; 95.34% CI, 0.713–0.937; P = .0032).
In one trial, 1,226 patients were randomly assigned to receive ziv-aflibercept (4 mg/kg intravenously [IV]) or placebo every 2 weeks in combination with FOLFIRI.[81][Level of evidence A2]
Patients who received ziv-aflibercept/FOLFIRI also had significantly improved PFS rates, with median PFS rates of 6.90 months compared with patients who received placebo/FOLFIRI, with median PFS rates of 4.67 months (HR, 0.758; 95% CI, 0.661–0.869; P < .0001).
In one trial, 1,226 patients were randomly assigned to receive ziv-aflibercept (4 mg/kg intravenously [IV]) or placebo every 2 weeks in combination with FOLFIRI.[81][Level of evidence A2]
Based on these results, the use of ziv-aflibercept/FOLFIRI is an acceptable second-line regimen for patients previously treated with FOLFOX-based chemotherapy. Whether to continue bevacizumab or initiate ziv-aflibercept in second-line therapy has not been addressed yet in any clinical trial, and there are no data available.
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Preserved source evidence · Not medical advice