Emily Chan, MD, PhD, Assistant Professor of Medicine, Vanderbilt University Department of Medicine, Division of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, discusses the investigatory agent aflibercept, a vascular endothelial growth factor (VEGF)-trap agent.

Aflibercept acts as a decoy receptor, which causes pro-angiogenic VEGFs to bind to its ligands rather than the correct VEGF receptors. Trapping VEGF with false receptors prevents tumor angiogenesis. Historically VEGF has proven to be an active target in colorectal cancer and is successfully inhibited at different points by other agents, such as bevacizumab.

Although aflibercept is not currently an approved agent promising data was released supporting its use in metastatic colorectal cancer at the 2011 ECCO/ESMO meeting. Multiple trials are currently underway looking at disease types that have demonstrated VEGF target efficacy.

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Dr. Emily Chan, from Vanderbilt-Ingram Cancer Center, Discusses the VEGF-Trap Agent Aflibercept

Dr. Chan Discusses the VEGF-Trap Agent Aflibercept

Emily Chan, MD, PhD, Assistant Professor of Medicine, Vanderbilt University Department of Medicine, Division of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, discusses the findings of the NO147 trial that examined adjuvant stage III colon cancer treatment.

The NO147 trial compared chemotherapy regimens with or without the addition of cetuximab (Erbitux) as an adjuvant treatment. The study initially planned to enroll 2300 patients but amended the goal to 3700 when a link between anti-epidermal growth factor receptor (EGFR) agents and 

The study found that metastatic colorectal cancer with a 

 mutation were unlikely to benefit from EGFR antibody therapies such as cetuximab or panitumumab (Vectibix). The NO147 trial arm receiving 5-fluorouracil (5-FU), folinic acid and oxaliplatin (modified [m]FOLFOX-6) plus cetuximab did not demonstrate any benefit for both mutated and wild-type 

A small subsection of the trial demonstrated an improved outcome for wild type or mutated 

 patients receiving 5-FU, FA, and irinotecan (FOLFIRI) plus cetuximab compared to FOLFIRI alone. These findings were surprising and will be the topic of further study.

Dr. Emily Chan from Vanderbilt-Ingram Cancer Center Discusses the Adjuvant Colorectal NO147 Trial

Emily Chan, MD, PhD

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Dr. Chan Discusses the VEGF-Trap Agent Aflibercept

Dr. Chan on the Adjuvant Colorectal NO147 Trial