Incidence and management of ZIv-aflibercept related toxicities in colorectal cancer

Table 3 Recommendations for Dose Modification and Treatment Delay for Zaltrap

Discontinue ZALTRAP for:	Severe hemorrhage
	Gastrointestinal perforation
	Compromised wound healing
	Fistula formation
	Hypertensive crisis or hypertensive encephalopathy
	Arterial thromboembolic events
	Nephrotic syndrome or thrombotic microangiopathy (TMA)
	Reversible posterior leukoencephalopathy syndrome (RPLS)
Temporarily suspend ZALTRAP:	At least 4 wk prior to elective surgery
	For recurrent or severe hypertension, until controlled. Upon resumption, permanently reduce the ZALTRAP dose to 2 mg per kg
	For proteinuria of 2 grams per 24 h. Resume when proteinuria is less than 2 grams per 24 h. For recurrent proteinuria, suspend ZALTRAP until proteinuria is less than 2 grams per 24 h and then permanently reduce the ZALTRAP dose to 2 mg per kg (RULE OF 2)