FDA just approved use of Zaltrap/afilbercept in combo with FOLFIRI for mCRC:

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  • janie1
    janie1 Member Posts: 753 Member
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    coloCan
    Had been wondering where you were? Thank goodness you are back. I haven't even read the article yet.

    ( Wish these new drugs could be used without folfiri or folfox. Wouldn't that be grand? )
  • tanstaafl
    tanstaafl Member Posts: 1,313 Member
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    Z(altrap), the mark of Z...
    Zaltrap (aflibercept) adds VEGF-B and PlGF to the VEGF A isoforms bound up by Avastin.

    Results for Folfiri vs Folfiri+Zaltrap(aflibercept): "The primary endpoint of OS ... 12.06 vs 13.5 months, P = .0032 ... results for secondary endpoints (PFS: 4.7 vs 6.9 months, P = .00007;... The cohort of patients with prior bevacizumab [Avastin] therapy demonstrated an attenuated benefit for aflibercept." With previous Avastin treatment the aflibercept results were, 6.7 months PFS, 12.5 months OS. This would shift the survivals of the remaining patients without prior Avastin treatment, slightly upward from 13.5 months.

    What I found in the literature was that cimetidine used long term (1+ yrs), especially with an initial CA19-9 biomarker determination, appears to me vastly superior to Avastin's results in enhancing stage III patients' survival, since Avastin had a negative result for stage III. I also found small studies that trend toward very favorable results in several metastatic/stage IV adenocarcinomas, including colorectal cancers.

    We decided to use cimetidine early on, continued long term if my wife was positive for CA19-9 (she was, her tumors are also CSLEX1 positve, a virtually quantitative determination for cimetidine benefit). She started cimetidine early, the first week (I think day #3) of diagnosis well before surgery, to maximize the anti-VEGF-A benefits along with cimetidine's immunological and EGFR signaling benefits.
  • pepebcn
    pepebcn Member Posts: 6,331 Member
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    tanstaafl said:

    Z(altrap), the mark of Z...
    Zaltrap (aflibercept) adds VEGF-B and PlGF to the VEGF A isoforms bound up by Avastin.

    Results for Folfiri vs Folfiri+Zaltrap(aflibercept): "The primary endpoint of OS ... 12.06 vs 13.5 months, P = .0032 ... results for secondary endpoints (PFS: 4.7 vs 6.9 months, P = .00007;... The cohort of patients with prior bevacizumab [Avastin] therapy demonstrated an attenuated benefit for aflibercept." With previous Avastin treatment the aflibercept results were, 6.7 months PFS, 12.5 months OS. This would shift the survivals of the remaining patients without prior Avastin treatment, slightly upward from 13.5 months.

    What I found in the literature was that cimetidine used long term (1+ yrs), especially with an initial CA19-9 biomarker determination, appears to me vastly superior to Avastin's results in enhancing stage III patients' survival, since Avastin had a negative result for stage III. I also found small studies that trend toward very favorable results in several metastatic/stage IV adenocarcinomas, including colorectal cancers.

    We decided to use cimetidine early on, continued long term if my wife was positive for CA19-9 (she was, her tumors are also CSLEX1 positve, a virtually quantitative determination for cimetidine benefit). She started cimetidine early, the first week (I think day #3) of diagnosis well before surgery, to maximize the anti-VEGF-A benefits along with cimetidine's immunological and EGFR signaling benefits.

    Thanks for the info.
    I was really interested in alfibercept.
    hugs my friend.
    ( hope to see you more often)
  • dmj101
    dmj101 Member Posts: 527 Member
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    FDA article makes it not sound all that great
    FDA report gastrointestinal bleeding and the severe hindering of wound healing..
    The only plus I saw was tumor shrink in 20% of participants in trials..
    I don't think I would jump on this..
    I think it needs more time.