Avastin May Help Fight Tough-to-Treat Ovarian Tumors
SATURDAY June 2, 2012 -- French researchers report that a targeted therapy already enlisted in the fight against colorectal cancer, lung cancer and kidney cancer may also have a role to play in recalcitrant ovarian cancer.
According to research being presented Saturday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, Avastin (bevacizumab) doubled the time to cancer recurrence in women who were not responding to traditional chemotherapy.
"This is the first time that there has been a significant advance in these difficult-to-treat patients," said study author Dr. Eric Pujade-Lauraine, head of medical oncology at Hopitaux Universitaires Paris-Centre site Hotel-Dieu, in France. "These data open a new era for biologics when chemotherapy is not doing its job in recurrent ovarian cancer."
According to Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic surgeon with Lenox Hill Hospital in New York City, some physicians are already using Avastin in these settings.
This trial, she said, "provides further evidence of benefit."
About one in five women with ovarian cancer is resistant to platinum-based chemotherapy or becomes resistant to it.
Avastin was the first in a class of drugs developed to inhibit angiogenesis, or the formation of blood vessels, which helps fuel a tumor's growth.
This study is actually the fourth phase 3 trial finding some benefit to using Avastin for different stages of ovarian cancer, said Dr. Jamal Rahaman, an associate clinical professor in the division of gynecologic oncology at Mount Sinai School of Medicine, in New York City.
The current trial involved 361 women whose cancers had returned despite having undergone four or more cycles of platinum-based chemotherapy.
Participants were randomly assigned to receive one of three platinum-based chemotherapy drugs alone or chemotherapy plus Avastin.
Women in the combination group lived an average of 6.7 months before their malignancy returned, compared with 3.4 months among women getting chemotherapy alone.
"It may not seem like three months is spectacular progression-free survival, but this suggests that angiogenesis drugs probably have a real role to play [in ovarian cancer]," Poynor explained. "We're defining how to use Avastin in ovarian cancer."
But there are some significant caveats that go with the findings.
Women taking Avastin had more side effects, including gastrointestinal perforations, hypertension and abscesses, the study authors reported.
Because of such side effects, the U.S. Food and Drug Administration recently revoked its approval of Avastin for the treatment of metastatic breast cancer.
Patients in this study were specifically selecting to minimize the occurrence of side effects.
"They were picking out the very, very best patients here, which does not necessarily translate to all patients with ovarian cancer," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.
The challenge now is to select those patients for whom Avastin would be most beneficial, said Rahaman. "The community is trying to figure out if we can identify those women who would get the most benefit so we can justify the cost and the increased side effects," he said.
A year's worth of Avastin runs about $100,000 a year in the United States, he added.
The drug is not yet approved by the FDA for ovarian cancer, although it is in Europe.
"This is very early research," Brooks said. "With time, as the data matures, we will begin to answer the question as to whether this drug is really worthwhile."
Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed medical journal.
The study was funded by Roche Inc., which makes Avastin.
The U.S. National Cancer Institute has more on ovarian cancer.
Posted: June 2012