SATURDAY, June 2 (HealthDay News) — 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.
More information
The U.S. National Cancer Institute has more on ovarian
cancer.
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