Clinical Research Papers:

Intraperitoneal ziv-aflibercept effectively manages refractory ascites in colorectal cancer patients

Chieh-Sheng Lu, Jen-Kou Lin, Wei-Shone Chen, Tzu-Chen Lin, Jeng-Kai Jiang, Shung-Haur Yang, Huann-Sheng Wang, Shih-Ching Chang, Yuan-Tzu Lan, Chun-Chi Lin, Hung-Hsin Lin and Hao-Wei Teng _

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Oncotarget. 2017; 8:36707-36715. https://doi.org/10.18632/oncotarget.13543

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Chieh-Sheng Lu,1,2,3, Jen-Kou Lin5,6, Wei-Shone Chen5,6, Tzu-Chen Lin5,6, Jeng-Kai Jiang5,6, Shung-Haur Yang5,6, Huann-Sheng Wang5,6, Shih-Ching Chang5,6, Yuan-Tzu Lan5,6, Chun-Chi Lin5,6, Hung-Hsin Lin5,6, Hao-Wei Teng3,4,5

1Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan

2Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

3Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan

4Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

5School of Medicine, National Yang-Ming University, Taipei, Taiwan

6Division of Colon and Rectum Surgery, Department of Surgery, Taipei Veterans General Hospital & National Yang-Ming University, Taipei, Taiwan

Correspondence to:

Hao-Wei Teng, email: [email protected]

Keywords: intraperitoneal injection, ziv-aflibercept, metastatic colorectal cancer, serum ascites albumin gradient

Received: May 22, 2016    Accepted: November 12, 2016    Published: November 24, 2016


Ascites related to metastatic colorectal cancer (mCRC) reduces patient survival and quality of life, and systemic chemotherapy is largely ineffective for managing ascites. Here, we examined the clinical efficacy of intraperitoneal (IP) ziv-aflibercept for managing refractory ascites in 15 mCRC patients who did not respond to standard chemotherapy. Fifty or 100 mg of ziv-aflibercept in 100 mL of saline solution were infused through a pigtail catheter and retained for 24 h. When the ascites drainage volumes were subsequently monitored, 73.3% of patients showed an objective response (OR) to IP ziv-aflibercept treatment. Patients with low Eastern Cooperative Oncology Group (ECOG) performance status or with serum ascites albumin gradients (SAAG) less than 1.1 g/dL had better responses to treatment, and 4 patients with SAAG less than 1.1 g/dL showed rapid objective responses (rOR). These findings indicate that intraperitoneal ziv-aflibercept therapy may be a highly effective means of treating refractory ascites in mCRC patients, and that SAAG may be predictive of a rapid response to this treatment.

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