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Avastin: Mixed Results Against Different Cancers

Drug improved survival by 4 months with cervical cancer, but no such benefit seen with brain tumors

WebMD News from HealthDay

Women taking the drug lived more than 3 months

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- Clinical trials investigating new uses for the anti-cancer drug Avastin have produced mixed results.

When combined with standard chemotherapy, Avastin extended the survival of patients with advanced cervical cancer by nearly four months, doctors reported in one trial.

However, two other trials found the drug proved of little use in treating newly diagnosed glioblastoma brain tumors.

All three studies appear in the Feb. 20 issue of the New England Journal of Medicine.

Avastin (bevacizumab) slows or halts cancer progression by preventing the creation of new blood vessels that provide the tumor with nutrients and oxygen.

The U.S. Food and Drug Administration has approved Avastin's use in combination with standard chemotherapy in treating some forms of colon, lung, kidney, ovarian and breast cancer. It also has been approved to treat recurring glioblastoma.

Cancer doctors hailed the drug's success in extending the lives of women with recurring or persistent cervical cancer.

"We've been trying to find a way to improve survival in cervical cancer for a very long time," said Dr. Don Dizon, an oncologist at Massachusetts General Hospital and a gynecologic cancer expert for the American Society of Clinical Oncology. "We haven't been able to make much progress. We've tried many different drugs and nothing has been successful." He was not involved with the current study.

Avastin extended survival by 3.7 months for these patients, the researchers reported. The U.S. National Cancer Institute funded the trial.

While four months does not seem like a long time, study co-author Dr. Lois Ramondetta said this amount of added lifespan could provide a crucial window for trying other treatments that could cure or slow the cancer.

"We have a new backbone for adding additional drugs to, to produce even longer survival," said Ramondetta, a professor at the University of Texas M.D. Anderson Cancer Center and chief of gynecologic oncology at Lyndon B. Johnson General Hospital, in Houston.

But there are drawbacks. Avastin is very expensive, with two 16-milliliter vials of the drug currently priced at more than $5,400.

Given that cervical cancer is preventable through pap smears and HPV vaccination, Dizon questioned whether such an expensive drug would be affordable for women who couldn't afford the basic preventive medicine that could have kept the cancer from occurring in the first place.

"If you can't afford screening with pap smears, it's unlikely you'll be able to provide women bevacizumab as treatment," he said.

Avastin also increased the risk of troubling side effects, including high blood pressure, thromboembolisms [clots in blood vessels] and holes in the gut called fistulas.

Lead author Dr. Krishnansu Tewari noted that these side effects did not include death, and contended that the increase in side effect risk was moderate and acceptable.

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