The high incidence of metastatic colorectal cancer creates a huge healthcare and socioeconomic problem worldwide. Basic therapy of advanced tumour consists in fluoropyrimidine-based chemotherapy, irinotecan and oxaliplatin.
Antiangiogenic biological preparations act synergistically with chemotherapy in first- and second-line palliative treatment. Aflibercept has earned its place in second-line therapy together with fluoropyrimidine-based chemotherapy and irinotecan after previous failure of first-line therapy.
Current state of knowledge might raise questions regarding the sequence of administration of bevacizumab, aflibercept and anti-EGFR antibodies. Aflibercept, inhibiting the same neoangiogenesis path as bevacizumab, however, has clearly shown efficacy and benefit even after bevacizumab failure, and its place in second-line regimes of palliative treatment is undoubtedly fully warranted.