AVASTIN

What's Wrong with Avastin?
Nothing really. It’s a wonderful drug that incorporates the brilliant insights originally articulated by Judah Folkman, MD, at Harvard University. Dr. Folkman reasoned that:

Cancers require oxygen and nutrients

These would need to be delivered by a blood supply

Tumors would avidly seek their own blood supply via humoral factors.

His groundbreaking work ultimately lead to the discovery of VEGF, as well as the FDA approval of Avastin, the monoclonal antibody that binds and inactivates circulating VEGF in patients. The problem isn’t with Avastin, it’s with the practice of oncology – the clinical trial process and the muddied waters that surround clinical utility of any drug, new or old.

There are no perfect drugs. There are simply drugs that work for certain patients. VEGF down-regulation is an attractive and highly appropriate therapy for a subset of cancer patients with many different diagnoses whose tumors use the VEGF pathway to their advantage. Avastin combined with carboplatin and taxol has improved the survival of lung cancer patients. Avastin plus folfox has improved survival for colon cancer patients. Avastin plus chemotherapy improves the survival of some breast cancer patients. The problem is that it doesn’t improve the survival of all cancer patients.

When the FDA rules on the clinical utility of a drug, they use a broad-brush approach that looks at the global outcomes of all patients, determining whether these glacial trends reflect a true climate change. The problem is that while Bethesda, Maryland may not be noticing significant changes in ocean levels, people who live on the Maldives are having a very different experience. As these scientists ponder the significance of Avastin, some cancer patients are missing out on a treatment that could quite possibly save their lives.

One cancer patient’s life saving therapy is another’s pulmonary embolism without clinical benefit. Until such time as cancer patients are selected for therapies predicated upon their own unique biology, we will confront one Avastin after another. Our solution to this problem has been to investigate the VEGF targeting agents in each individual patient’s tissue culture, alone and in combination with other drugs, to gauge the likelihood that vascular targeting will favorably influence each patient’s outcome. The results to date in patients with non-small cell lung cancer, colorectal cancer and even rare tumors (like medullary carcinoma of the thyroid) suggest this to be a highly productive direction for future development.

tropicgirl2780 said:

Avastin
I originally had 12 weeks of Avastin, Carboplatin and Pemetrexed. I started on Dec. 23rd of 2009. I have stage 4 NSCLC. I stopped the pemetrexed and carbplatin and have been on avastin only since July 2010. It is working wonderfully in my instance and i haven't had any side effects to speak of. I think everyone's chemistry is different and each cancer is different depending on the body it infects. I am sorry for your loss. I do know that it has done a lot of good for a lot of people though.

avastin
I also have NSCLC and have been treated with Carboplatin, Taxol and Avastin. I have one full treatment with these 3 drugs then I go to just avastin for maintenance every 3 weeks for who knows how long. I am in a clinical trail here in High Point, NC. This place has great doctors and great staff. My wife and I came here from Florida to be treated here.
After 2 bouts of full chemo they did a CT scan my tumors have decreased by 23% and at this moment has not spread anywhere else. I will be rechecked in 6 weeks which 3 weeks after my last full chemo bout. So far everything is moving in the right direction. I will add there are 4 things that are very important to all cancer patients, Keep your God in your life, keep your family close, trust in your doctors and most of all never give up. I was diagnosed with NSCLC that metastasized to liver and chest lymph nodes. I was given 8 months to possibly 1 year to live depending how I reacted to the chemo. With my last chemo coming up in 3 weeks the will retest again and if it shows more shrinkage of tumors and the cancer has not spread I will be considered stable and will start my maintenance program of just avastin. Yes I still have stage IV cancer and yes I am considered terminal. And the good news is if I am considered stable my life expectancy goes up to 3 1/2 to 4 1/2 years. I wish everyone good luck and God speed. I pray for all of you.
AlanR