Aflibercept (Zaltrap) is not recommended for use within NHS Scotland for use in combination with irinotecan/5-fluorouracil/folinic acid (FOLFIRI) chemotherapy, aflibercept is indicated in adults with metastatic colorectal cancer (mCRC) that is resistant to or has progressed after an oxaliplatin-containing regimen.In one randomised, double-blind, phase III study, aflibercept plus FOLFIRI chemotherapy regimen resulted in significantly longer overall survival compared with placebo plus FOLFIRI chemotherapy regimen.  However the effect was of relatively modest clinical benefit. The submitting company did not present a sufficiently robust economic analysis and in addition their justification of the treatment’s cost in relation to its health benefits was not sufficient to gain acceptance by SMC. For more details, go to http://www.scottishmedicines.org.uk/SMC_Advice/Advice/878_13_aflibercept_Zaltrap/aflibercept_Zaltrap