Trade name

ZALTRAP^®

What Aflibercept is and what it is used for?

• Aflibercept is a monoclonal antibody that targets to the protein called vascular endothelial growth factor-A (VEGF-A), VEGF-B and placental growth factor (PIGF), thereby inhibiting the binding of these proteins to its receptors. As a result, aflibercept prevents the growth of the new blood vessels. This may interfere with cancer cell growth and expansion.
• Aflibercept is used in combination with irinotecan and fluorouracil-based chemotherapy to treat colorectal cancer that did not respond to an oxaliplatin-containing chemotherapy.

How Aflibercept is given?

• Aflibercept is given as an infusion into a vein over 1 hour.

What should I know while receiving Aflibercept?

• An allergic reaction may happen during or shortly after the infusion, causing fever and chills, breathing difficulties, swelling of throat or face, or hives. Tell your nurse right away if you feel unwell during an infusion.
• Do not receive this drug when you are pregnant or breastfeeding.
• Men and women should use effective contraception during treatment and for at least 3 months after the treatment ends.
• Do not receive any kind of vaccination without doctor's approval.
• You will be checked regularly by your doctor. The timing and dosing of your treatment may be changed based on the test results or other side effects.
• If you need surgery, tell the surgeon ahead of time that you are using bevacizumab. You may need to stop this drug at least 28 days before surgery and may be restarted based on adequate wound healing.
• The existing health problems may affect the use of aflibercept. Let your doctor know if you have any other medical problems, especially if you have heart, liver or kidney problems, or have any unhealed wounds.

Common side effects

• Low white blood cell count

You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, a painful urination or wound that becomes red and swollen.

• High blood pressure

Tell your doctor if you have problems with blood pressure. Your doctor will monitor your blood pressure and may prescribe medications if necessary. Seek medical help at once if you suddenly hit with a severe headache or have blurred vision.

• Eye irritation

You might have dry eyes or infection in the eyes. Tell your doctor if this happens. Medicines can be given to relieve symptoms.

• Mouth sores

Your doctor can give you medicines that help you ease the discomfort. Good mouth care will help prevent mouth sores.

• Loss of appetite

Try to eat in small quantities and have frequent meals. If your appetite does not get any better after a few days, tell your doctor.

• Fatigue

Try to pace yourself and rest as much as possible. Seek medical advice if fatigue does not go away when you rest and sleep.

• Diarrhea

This is more common in patients taking aflibercept in combination therapy with fluorouracil and irinotecan. Talk to your doctor and ask for advice. Drinking plenty of water and dietary changes can improve diarrhea.

• Elevated liver enzymes

This is usually mild and may return to normal after treatment has ended. Seek medical help right away if you have yellowing of the skin or eyes, dark or brown urine, or pain in abdomen, as these can be signs of liver toxicity.

• Protein in the urine

This is more common in patients receiving combination therapy. This condition means your kidney is not working well. Talk to the doctor if you have persistently bubbly or foamy urine.

Less common side effects

• Muscle pain

Talk to the doctor if the pain is bothering you, they can give you medicine to help ease pain.

• Headache

Tell your doctor if this happens. Be sure to ask your doctor before taking any pain relievers.

• Hand-foot syndrome

Your may have redness, swelling, and pain or peeling on the palms of hands and the soles of feet. This is usually mild. Tell your doctor if this happens. Avoid long exposure to hot water and activities that cause rubbing or pressure on your skin.

• Bleeding risk

Aflibercept can increase the risk of bleeding. Let your doctor know if any unusual bleeding occurs or if you find unexplained nosebleed or have blood in the sputum.

Rare but serious side effects

• Arterial thrombotic events

Aflibercept can cause blood clots in your arteries. It is rare but can lead to serious conditions, including heart attack or stroke. The doctor would stop your treatment if a patient develops a severe blood clot in the arteries.

• Bleeding in the digestive tract

Rarely, aflibercept can cause a hole in digestive tract. Seek medical help at once if you have severe pain or cramps in the abdomen, blood or tarry stools, throwing up blood, or vomit that looks like coffee grounds.

• Delayed wound healing

Be careful when using sharp objects. Talk to your doctor if you have an unhealed wound or have any wound problems.

More Information

• There are many drugs may affect how aflibercept works. Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
• Drink at least 6 to 8 glasses of water every day can help make your recovery a smoother process.
• Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarette smoking during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.