aflibercepte

Aflibercept is a recombinant fusion protein that acts as a decoy receptor for vascular endothelial growth factor (VEGF). It combines the VEGF-binding domains of human VEGF receptors 1 and 2 with the IgG1 Fc portion, enabling high-affinity sequestration of VEGF-A, VEGF-B, and placental growth factor. By trapping these ligands, aflibercept inhibits VEGF signaling, reducing angiogenesis and vascular permeability in target tissues.

Clinical use of aflibercept falls into two main areas. In ophthalmology, intravitreal aflibercept is marketed under the name Eylea and is used to treat neovascular age-related macular degeneration, diabetic macular edema, diabetic retinopathy with macular edema, and macular edema following retinal vein occlusion. Dosing typically involves injections every 4 weeks for a loading phase followed by extended intervals, adjusted to the individual treatment response.

In oncology, aflibercept is administered intravenously in combination with chemotherapy (notably with FOLFIRI) for metastatic colorectal cancer in patients who have progressed after oxaliplatin therapy. It has been investigated in other solid tumors, but approved indications are primarily colorectal cancer in this systemic setting.

Adverse effects vary by route of administration. Ophthalmic use can cause conjunctival hemorrhage, eye pain, floaters, increased intraocular pressure, and, rarely, endophthalmitis. Systemic use may lead to hypertension, proteinuria, thromboembolic events, wound-healing impairment, fatigue, and infusion-related reactions.

Biochemically, aflibercept represents a targeted anti-angiogenic therapy with distinct indications in eye disease and cancer.