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, Hao Wei Teng*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish
Pages (from-to)36707-36715
Number of pages9
Issue number22
StatePublished - 24 Nov 2016


  • Intraperitoneal injection
  • Metastatic colorectal cancer
  • Serum ascites albumin gradient
  • Ziv-aflibercept


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