ZIV-AFLIBERCEPT INJ
Clinical Criteria Summary
Exclusion Criteria
- Major surgery within prior 28 days
- Non-healing wound or fracture
- Recent venous or arterial thromboembolic event
- Nephrotic syndrome or thrombotic microangiopathy (TMA)
- Uncontrolled hypertension
- Chronic diarrhea and/or dehydration issues
- Bleeding issues or at high risk of bleed (i.e. GI bleed, hematuria, etc.)
- Pregnancy
- Lactating
Inclusion Criteria
- Care provided by a VA/VA Community Care Hematology or Oncology provider
- Goals of care and role of palliative care consult has been discussed and documented
- Eastern Cooperative Oncology Group Performance Status 0 or 1
- Metastatic colorectal cancer with progressive disease on an oxaliplatin-based regimen
- Intended use of ziv-aflibercept is in combination with fluorouracil, leucovorin, irinotecan (i.e. FOLFIRI)
- Patient is irinotecan-naïve
- Adequate hematologic function defined as Absolute Neutrophil Count > 1500/mm3 and platelets > 100,000/mm3
Additional Inclusion Criteria (If Applicable)
- For patients who can become pregnant and patients with partners who can become pregnant: Counseling provided on potential risks vs benefits of treatment and the use of effective contraception during therapy and for 3 months after stopping treatment