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Studies suggest Avastin can help ovarian cancer patients
December 29th, 2011
05:35 PM ET

Studies suggest Avastin can help ovarian cancer patients

Two studies released in this week's New England Journal of Medicine suggest the drug Avastin may benefit some ovarian cancer patients.

The two studies found that adding Avastin to chemotherapy treatment can stall the growth of cancer by almost four months. Avastin, which has the generic name Bevacizumab, stops the growth of blood vessels that feed cancerous tumors, say researchers. However, it is still unclear if it will extend patients' lives.

Ovarian cancer is the fifth most common cancer for American women. According to the National Cancer Institute, 15,000 women in the United States die from it each year. It is frequently undetected until it has advanced to a late stage, making it the most fatal of all gynecological cancers.

While Avastin has been approved by the FDA for some cancers, including kidney, brain, and colon cancer, it has come under fire for its use in breast cancer treatment. It was initially approved for breast cancer treatment in 2006. But late last month, the FDA revoked Avastin’s approval for breast cancer because they felt the benefits did not outweigh the side effects. Avastin is produced by Genentech, a subdivision of Roche Pharmaceuticals.

The two studies were funded by Roche.

One study was led by the Gynecological Oncology Group and surveyed 1,873 women internationally who had been newly diagnosed with stage III or IV cancer. Women who received the drug as part of their chemotherapy regimen were found to increase their rate of progression-free survival, or the length of time before the cancer worsened, to 14 months. It was a four-month increase over patients who were just given the placebo and had a progression-free survival period of 10 months.

Dr. Robert Burger of the Fox Chase Cancer Center in Philadelphia was the lead author of the study. “This is a new paradigm in the treatment of this disease,” says Burger. He says that patients with Stage III or IV ovarian cancer “deserve to have this treatment as an option.”

The other study, led by the International Collaboration on Ovarian Neoplasms, looked at more than 1,500 women internationally. This study included women with less severe stages of cancer. Authors found women with the placebo had a 22-month progression-free survival period, versus 24 months for those on Avastin, for a two-month difference before the cancer worsened. However, when looking just at patients with stage III or IV cancer, the progression-free survival period for those on Avastin increased by over three months.

While Avastin can delay the growth of cancers, researchers were unable to definitively say how it impacts survival rates for patients. They say that it will still take a few more years of tracking before they can fully determine that. Full survival data is not expected until at least next year.

In addition, patients who did take Avastin in both studies did experience some side effects, including increased hypertension and tearing of the gastrointential wall. However, according to both studies, quality of life was not impacted by the side effects.

“I think this data is compelling. Improved control of disease is always a good endpoint, but living longer is a better endpoint,” says Dr. Joanne Mortimer, who sat on the FDA advisory committee looking at Avastin for the treatment of breast cancer. Mortimer is vice-chair of the Department of Medical Oncology at the City of Hope Comprehensive Care Center in Duarte, California. She is not connected to the studies and is a bit cautious. “Without increased survival rates, are the side effects worth it?”

Last week, the European Commission approved the use of Avastin in the treatment of ovarian cancer patients. However, Genentech says that based on the current findings of the studies, they will not ask the FDA to consider it for ovarian cancer treatment in the United States. They are still waiting for full survival data.


soundoff (40 Responses)
  1. Gene

    Avastin like so many cancer drugs has great promise but that promise is tempered by the inability to target the drug specifically to the tumor, thus a myriad of side-effects. Targeting will represent a quantum leap in cancer therapy when it happens.

    December 29, 2011 at 19:31 | Report abuse | Reply
    • yuri pelham

      it doesn't prolong survival. you get false hope and needless suffering at great cost. another big pharma rip off

      December 31, 2011 at 10:03 | Report abuse |
    • Judy

      Taking any cancer drug is up to the person. Do you want to prolong your life a few extra months? Are the side effects worths it? Family and friends should not put the un-necessary pressure on their loved ones.

      January 1, 2012 at 18:57 | Report abuse |
  2. Alicia

    A glimmer of hope for so many women. After 3 years of chemo for Ovarian Cancer, my mom demanded to try this drug (this was in 2007). The doctors gave in (mind you she had to pay for it out of pocket)...it just too little to late for her, but I feel at peace knowing she was a pioneer for this drug for Ovarian Cancer patients...there's hope! Hold onto it!

    December 29, 2011 at 19:45 | Report abuse | Reply
  3. Dan

    What other problems will it cause?

    December 29, 2011 at 19:56 | Report abuse | Reply
    • EllieKate

      My sister was on Avistin for several months. Eventually, her skin became so fragile, that when she would bend her arms, her elbows would split open and bleed. I think she had been on it 6-8 months by that time. It was also making her blood pressure roller coaster by rising dramatically and then dropping. That side-effect was difficult to control.

      December 29, 2011 at 20:51 | Report abuse |
    • EllieKate

      I forgot to add that her ovarian cancer was diagnosed at Stave 3c in 2007. I think she was on Avistin in 2009 and her cancer did not seem to progress very quickly during that time.

      December 29, 2011 at 20:53 | Report abuse |
    • Science guy

      Dan,

      Avastin is a VEGF inhibitor. That is, it blocks molecules necessary for blood vessel growth and formation. Tumors can only grow large if they have a blood supply to support their growth. The problem with Avastin is that it blocks ALL new blood vessel formation, not just that in the tumor. Avastin is also used for age related macular degeneration to vessel formation that causes blindness. Again, you see global, total body side effects involving blood pressure, bleeding, etc...

      December 29, 2011 at 21:38 | Report abuse |
    • H

      EllieKate: A side effect of all chemotherapies is skin break down....that is right in all of the literature

      December 29, 2011 at 21:46 | Report abuse |
    • Chelle

      Science Guy –

      It is a miracle drug in the treatment of macular degeneration . My Ma was part of a test study in its use. She lost over 90% of her vision due to the rogue blood vessles. Once she received the treatment (though very scary for her) she recovered a great portion of the lost vision. I believe it is a wonder drug (IMHO).

      January 4, 2012 at 09:47 | Report abuse |
  4. JK

    Is CNN somehow invested in Avastin? I am absolutely shocked and disgusted by this article! The findings from the two studies were DISAPPOINTING and considered a failure by the industry! "Avastin and ovarian cancer: The embattled cancer drug Avastin was pitted against ovarian cancer in two new studies and showed modest, disappointing results. It stalled progression by just a few months, caused high blood pressure and other side effects and did not appear to increase survival for most women. The Food and Drug Administration recently revoked approval of Avastin for breast cancer. It is not approved for ovarian cancer in the United States and that's less likely to happen now." How on earth does CNN publish an article saying Avastin helps ovarian cancer? Avastin absolutely does not help with ovarian cancer and will never receive FDA approval as a treatment for ovarian cancer. Shame on you CNN, this is tremendously poor journalism.

    December 29, 2011 at 21:02 | Report abuse | Reply
    • Spotimom

      My MIL has been on Avastin for the past 5 months in conjunction with chemotherapy. Now, she will be on it as a maintenance drug while she takes a break from chemo. I find it surprising that it is not FDA approved for ovarian cancer, but it is definitely being used. Oh and we'll take an extra 2 months if we can!

      December 29, 2011 at 21:25 | Report abuse |
    • H

      JK you say ..."disappointing results. It stalled progression by just a few months" as an oncology RN I know that stalling progression by just a few months is huge for cancer patients especially if they are late stage...so until you are placed in this unfortunate situation please do not say that stalling progression by just a few months is disappointing. Furthermore high blood pressure can be managed with other medications. Late stage cancer isn't about cure or survivorship being extended in most cases it is about stable disease hopefully for extended periods of time but it doesn't always work out like that. Let us also consider that these drugs are tested in clinical trial settings and often times the majority of people that consent to these studies have exhausted all other cancer treatements.

      December 29, 2011 at 21:43 | Report abuse |
    • UCCF

      Your response is incredibly biased, not to mention inaccurate. You can't say that it "did not appear to increase survival" – the article is clear that survival data is not yet available, and Genentech has stated that they're not going to look for FDA approval until the survival data comes out in a year or so. For cancer trials, you'll always get progression data before survival data, and the progression data shows a 2-4 month increase in delaying progression. While that's more disappointing than if it had shown 12-18 months increased disease-free survival, it's not nothing, particularly in aggressive cancers like ovarian.

      This is shaping up to be like the breast battle – is progression-free survival enough to merit approval? The FDA said no on breast, and that's likely why GNE is holding off on submitting this until the overall survival data is available.

      I'm not sure what Avastin, Roche, or Genentech ever did to you, but your level of anger at this story seems over the top, at best. You exhibit little knowledge of the pharmaceutical approval process (or of standards of journalism, for that matter).

      December 29, 2011 at 22:50 | Report abuse |
    • yuri pelham

      false hope... needless suffering...great cost.... doesn't prolong life.

      December 31, 2011 at 10:06 | Report abuse |
  5. RobertC

    Once again, the rest of the world makes progress against disease, while here in the United States, the FDA's pettifogging obstructionism obstructs opportunity. When are we going to get rid of this overblown bureaucratic dinosaur?

    December 29, 2011 at 21:40 | Report abuse | Reply
  6. LMH

    "Avastin is produced by Genentech, a subdivision of Roche Pharmaceuticals.
    The two studies were funded by Roche."

    JK's comment above is correct. Please note that the "poster" of this article, Ms. Kounang, is not a doctor, pharmacologist, or nurse. She has a bachelor's degree in science and technology studies and doesn't even specialize in medical journalism.
    http://www.hvc-inc.com/clients/cnn/bia2/bio10.html

    CNN should remove this false hope story.

    December 29, 2011 at 21:55 | Report abuse | Reply
    • UCCF

      I'm not sure what your point is – are you upset that drug companies pay for studies, or that journalists reporting on medicine don't all have medical backgrounds?

      If drug companies didn't fund studies, there would be no drugs. Do you want the government running it instead? We'd probably still be waiting for penicillin to be approved.

      December 29, 2011 at 22:58 | Report abuse |
    • LMH

      The point is that Marilynn Marchione, a distinguished medical writer at the Associated Press, interpreted the studies correctly in her article, "Avastin disappoints against ovarian cancer."

      December 30, 2011 at 00:08 | Report abuse |
  7. Ed Zachary

    I agree with JK. The local paper in my area carried this story with a headline about disappointing results and told of very small benefit for huge cost, which seems more appropriate considering the content of the story. Avastin can cost $100,000/year to take. It seems to provide the ovarian cancer patients with at most a couple months more time, with significant risk of side effects. This doesn't seem like a good trade off at all.

    December 29, 2011 at 22:06 | Report abuse | Reply
    • UCCF

      Trade off is in the eye of the beholder many times. If you're the one with stage III+ ovarian cancer, you might be very grateful for the chance to spend another 3-4 months with your family, not tethered to a hospital bed getting chemotherapy treatments that leave you drained of energy and unable to do almost anything. The cost is high, but saying it's $100K without context is meaningless – what are the costs of alternative treatments? Standard of care chemo certainly isn't free, and it's also not without a risk of side effects.

      These are the tough calls that the FDA (and the drug companies) have to make. No one said it's easy, and they'll struggle with this like they struggled with the breast cancer decision (particularly if the overall survival numbers don't show a statistically significant improvement). Though I suspect that if there's no bump to overall survival Genentech won't even bother filing for approval – it's not likely that they'd get a different outcome than they got for the proposed breast cancer indication.

      December 29, 2011 at 22:56 | Report abuse |
  8. Mick

    I am confused. Avastin is getting blasted and losing FDA approval and won't be covered by insurance because it only extends life by 4 months, maybe, in some patients, and causes unbelievably harsh side effects meaning the quality of life for those 4 months is horrid. Yet this article starts out with all positives on how great Avastin is. I would seriously like to know if I am reading an advertisement by Genentech, or is there some other motivation by CNN to shill Avastin? This is why the whole prescription drug industry needs a major overhaul. When a drug with millions invested turns out to be a flop, they won;t admit it and will try like hell to recoup the investment. Its not the right model.

    December 29, 2011 at 22:28 | Report abuse | Reply
  9. jon

    The approach of using chenicals to eradicate or fight cancer seems very amateurish. If the body creates the cancer, the body can eliminate it naturally. The key is to discover how to reverse cell growth and manage its growth or elimination within the body, thus paving the way for regrowing hearts, lungs, and other organs rapidly. How rapidly? There's no reason that science can't grow a heart in under a minute, or obliterate a tumor in the time it takes to enter and leave a doctor's office. If anyone says we can't, that's baloney. Everything that science teaches us today is medieval and quaint. If I have ovarian cancer, I should be able to swallow a pill that stimulates my body to eliminate that cancer immediately. Months? That's ridiculous.

    December 29, 2011 at 22:47 | Report abuse | Reply
    • D

      Wow, you're such a genius. Why don't you get an MD PhD and do all of this work for your thesis if you think it is so easy. Also, not possible to get ovarian cancer if you don't have ovaries, Jon.

      December 30, 2011 at 00:05 | Report abuse |
    • Elizabeth

      D, your ridicule isn't educational, but shows that you want to keep information for the few.
      Jon, none of these medicines work in a minute. The body has a trillion cells (and it may be more; I don't recall), and the blood system goes by these cells through tiny capillaries. And delivery of a drug does not guarantee, no matter what the drug is, that the drug will enter a cell. Any drug that will kill any cell is dangerous and may kill good cells too, so some drugs must be given slowly over time to protect the body from serious damage. There are several theories about different kinds of chemicals that treat cancer. Good luck on your reading and research.

      December 30, 2011 at 00:31 | Report abuse |
  10. Elizabeth

    O.K., what does Dr. Burzynski say about it? He does use other forms of chemo therapy along with his research, but I don't want to just hear from the FDA about important cancer findings. My husband is on Avastin, and yes, it has stalled the cancer. The only side-effect is high blood pressure within the liver system (portal hypertension), and, so IF the cancer is completely cured, he could be back to square one with liver failure, and (unlike Steve Jobs) he wouldn't be a good candidate for liver transplant unless his body is cancer free for five years (and do we trust that?) because anti-rejection drugs can bring on cancer again. We are still very happy to have this medicine, but there must be OTHER medicines besides Avastin; we KNOW there are other medicines that the FDA could approve, have the tests and patents for, but won't approve because they don't want anything but an already big business to make these pharmaceuticals. It is nothing short of murder, and I'm waiting for when Burnham Woods moves to Dunsenane (sp?). (Yes, they do abuse power like Macbeth.)

    December 30, 2011 at 00:24 | Report abuse | Reply
  11. Albert

    I have nothing against synthetic drugs. But I know of someone who was helped cured by a food supplement. She told me that what she was taking is a kind of mushroom that has 99.4% preventive rate to having cancer and 90% complete recovery rate. This gives me a goosebump because i seen her while she still was suffering from breast cancer and now she looks like nothing dreadful had ever happened to her. physician list

    December 30, 2011 at 08:32 | Report abuse | Reply
  12. Survivor

    I'm currently on Avastin for Ovarian Cancer and yes, i struggle with knowing how much each treatment costs and know I'm lucky to have an insurance plan that covers this expense. How do I reconcile whether extending my life a few months is worth the 100's of thousands of dollars I have poured into it? Mainly because i truly believe somewhere along the line science will find a cure for Ovarian Cancer. Right now there is no cure, just treatment to extend your life. We have figured out how to cure Breast Cancer, Prostate Cancer... so many of the cancers but not Ovarian. I know that to get there, we have to have awareness, outrage at the number of deaths and an investment in research. Avastin will not be THE drug that cures Ovarian cancer, but I hope that if my granddaughters ever have to face this disease, maybe Avastin will have led to their cure....

    December 30, 2011 at 09:01 | Report abuse | Reply
  13. B

    Drugs, Drugs, and more Drugs....
    Broke, Broke, and more broke.....
    No healthier....

    December 30, 2011 at 14:19 | Report abuse | Reply
    • yuri pelham

      false hope.... needless suffering

      December 31, 2011 at 10:54 | Report abuse |
  14. Lindsey

    It wasn't mentioned in the article that this drug costs upwards of $100,000 per year. So if your insurance doesn't cover it, and many do not, guess you just die, right?

    I would like a breakdown from Genentech detailing exactly why this drug costs $100,000 per year. How is it justified?

    December 30, 2011 at 14:50 | Report abuse | Reply
    • yuri pelham

      no. Rather you are spared false hope and needless suffering. The oncology – pharmaceutical community are taking advantage of suffering dying patients. One of the most successful criminal enterprises in human history. Both groups think they are doing good. In half the cases they are. The other half absolutely deplorable. The accusation I make is there's little effort to distinguish, the informed consent process is slanted toward futile treatment. There's no one left to protect the patient. Primary care doctors used to play this role. But they have been turned into data entry technicians and for the most part are useless (to the patient) servants of the medical industrial complex. The American public is totally clueless.

      December 31, 2011 at 10:52 | Report abuse |
  15. Ed Zachary

    Lindsey, even if you have the $100,000, you just die. That's what this discussion is all about. This drug does not cure ovarian cancer, it just temporarily extends your life up to about four months for some people, and less for most people. If you're dying of ovarian cancer, that could sound like a long time, maybe someone could develop a real miracle cure during those four months and you would be saved. Whenever you discuss cancer cures, someone comes up with an anecdote about themselves or a relative taking the medicine, or curing themselves with oyster shells or apple seeds or something, but the scientific statistics say you spend the $100K for this drug and it doesn't do much of anything for ovarian cancer.

    December 30, 2011 at 18:57 | Report abuse | Reply
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  17. Gregory Pawelski

    Because the FDA has approved Avastin for treatment of other cancers, physicians are free to use it as they see fit, and some prescribe it for women whose ovarian cancer has recurred or returned after shrinking. Medicare pays for Avastin for recurrent ovarian cancer, as do many large insurance companies.

    But sorting out patients who might benefit from those who won’t is impossible at present. "We desperately need to figure out a way to predict the folks who are going to respond to the drug versus the folks who will only get side effects of the drug," said Otis Brawley, chief medical officer of the American Cancer Society. Studies searching for such a test are ongoing.

    There is a valid biomarker for Avastin.

    http://cancerfocus.org/biomarker_for_avastin/46708#comment-6692

    December 30, 2011 at 23:05 | Report abuse | Reply
  18. Suzyq

    What they need to do for ovarian cancer is have mandatory testing for women once they reach a certain age like 40 for instance. The ultra sound is only around $200 bucks or so and would save so many women from this hell. Prevention is key, once you have this your so screwed. Simply solution

    January 1, 2012 at 18:09 | Report abuse | Reply
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    Ovarian cancer is currently treatable if you can arrest it on its early stages. Therefore, early diagnosis is very very critical. ,':,:

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