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Avastin or standard chemo treatment

mslayd02
Posts: 9
Joined: Feb 2012

My husband was just diagnosed with stage 4 gastric cancer and it has metastasized to his liver. We are now faced with trying to decide whether to go with the standard chemo treatment or take part in a clinical trial where they will replace Epirubicn with Avastin. We have gotten a second and 3rd opinion and both say chemo is the best treatment. The main Dr and the 3rd Dr we went to see says the best choice is the clinical trial with the Avastin but really popular cancer Dr in the community says why take a chance on a drug that has not been proven to be effective when there is treatment that has been proven. I agree with him but I also know the usual is not always the best.
Has anyone ever used Avastin for gastric cancer? Also has anyone had chemo work well enough to have surgery?

snallipogu
Posts: 2
Joined: Jul 2011

My mum will be starting Avastin this week. She's also stage 4. However, she has already been on two different chemo regimens (folfox and then irinotecan/cisplatin). The second worked for a while but now we need to try a different regimen.

I found this article about a previous study with avastin/gastric. See http://pharmastrategyblog.com/2010/02/roches-avastin-fails-in-stomach-gastric-cancer.html/

What are the requirements for the clinical trial? Can you go on stand chemo first and if that fails enroll in the trial? You may want to contact the clinical trial coordinator and discuss these options with her.

have2believe
Posts: 135
Joined: Dec 2010

I'm a bit confused by avastin...if it didn't produce favorable results, what is the benefit? I mean, I know there's a reason and there's more to this, but I'm trying to understand. Is it that the study showed benefit, but the benefit amount was not as favorable as they aimed/ hoped for? Also, is it something that can be approved by insurance or do you have to enroll in a clinical trial? If there's good reason, I'm going to ask my mom's dr about adding avastin.

mslayd02
Posts: 9
Joined: Feb 2012

The clinical trial did not show favorable results but what they did find that it did not work in Asian people but it appeared to be helpful in people from north and South American decent. The way she explained it to us was that the gastric cancer seems to appear in different areas of the the stomach depending on the region.

So at this point it has not been approved to used in gastric cancer, so insurance will not pay for it. So I think you have to get it in a clinical trial. Now with that being said, since I posted this we have gone in for 3 different opinions and all but 1 of the doctors agreed that using Avasitn was NOT the best 1st line of treatment for my husband and that was due the clinical trial testing to see if it is actually helpful even in people in North and South America. So there is not concert evidence it will help in stomach cancer, so we have decided not to do it.

have2believe
Posts: 135
Joined: Dec 2010

If you have not started treatment, I'd seriously consider a clinical trial. Because most people eligible for phase 3 clinical trials must not have been on any previous chemotherapies and that will leave you with more options. You also can switch back to the standard therapy if side effects are too severe, etc.

mslayd02
Posts: 9
Joined: Feb 2012

That was our initial thinking too but after speaking to 3 other oncologist, they felt that going with the standard chemo treatment(EOF) which has already been proven to work in stomach cancer as opposed to putting 3 months into a clinical trial that has no real bases on working in stomach cancer first. Once we started thinking about it it made since because in 3 month it may spread to other parts of the body if the Avastin really doesn't work. We are not opposed to clinical trials and hope that if this isn't successful there will be other opportunities, we were just opposed to starting out in a phase 2 clinical trial for his first treatment.

have2believe
Posts: 135
Joined: Dec 2010

EOF or EOX have had good results for many. I hope the side effects are manageable and for success in treatment. Please keep us posted!

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