Chemo Over

I completed my
I completed my carbo/taxol/avastin in late October. I began a one year, every three weeks maintenance with Avastin. The body aches are the worst side effect that I have. I am scheduled for a CT this month, so I guess I'll know a little more of how effective it has been. Best wishes to you!!

carolenk said:

Partial remission
If your CA-125 is < 35 but your scan is not quite NED, you can consider yourself in a partial remission.

I will see if I c the study comparing Avastin alone for indolent

Congratulations at arriving at this point. Next step: NED.

Avastin as single-agent therapy
Bevacizumab Shows Significant Single-Agent Activity in Ovarian Cancer
Zosia Chustecka
Authors and Disclosures
November 29, 2007 — The angiogenesis inhibitor bevacizumab (Avastin, Genentech) has demonstrated significant single-agent activity in patients with relapsed epithelial ovarian cancer, greater than that shown in any other epithelial cancer, with the exception of renal cancer.

Two phase 2 trials reported in the November 20 issue of the Journal of Clinical Oncology "convincingly demonstrate this efficacy," writes editorialist Stanley Kaye, MD, from the Royal Marsden Hospital and Institute of Cancer Research, Sutton Surrey, United Kingdom, in an accompanying editorial. "The drug's potential impact in this disease should not be underestimated," comments Dr. Kaye.

Both trials were conducted in patients with relapsed ovarian cancer, although the patient populations differed. The Gynecology Oncology Group (GOG) study (GOG170D) recruited 62 patients who had received only 1 or 2 previous chemotherapy regimens, 36 of whom were platinum resistant. In the other study, the manufacturer-sponsored Genentech AVF 2949 trial, all 44 patients were platinum resistant and were also resistant to topotecan and liposomal doxorubicin.

In both studies, bevacizumab (15 mg/kg every 21 days) clearly demonstrated single-agent activity, Dr. Kaye comments, with objective response rates of 21% and 16%, respectively. In addition, 32 of 62 patients (52%) and 27 of 44 patients (64%) achieved stable disease with the median progression-free survival of 4.4 and 4.5 months, respectively.

The drug was well tolerated in the GOG170D study. Only 2 patients discontinued the drug because of adverse effects, and "it is encouraging that several patients received treatment with bevacizumab for 30 to 35 cycles without unacceptable toxicity," the researchers comment. The observed toxicities "seem to be consistent with expectations" and included hypertension (grade 1 in 12.9% patients and grade 3 in 9.7%), proteinuria (grade 1 – 2 in 30.6%), and hemorrhage (grade 1 in 22.6%). These adverse effects were "manageable and mild in the majority of cases," with the exception of 1 patient, who developed grade 4 proteinuria. That patient withdrew from the study, and the proteinuria resolved on discontinuation of the drug.

The Genentech study was stopped prematurely because of concern about toxicity, specifically the rate of spontaneous bowel perforation (11%), which was higher than has previously been reported (up to 3.7%). In addition, the rate of arterial thromboembolic events occurred at a higher incidence in this trial (6.8%) than has previously been reported for bevacizumab. Three deaths were thought by the investigators to be related to the drug.

Why there should be such a difference in the toxicity observed is unclear, and the numbers are too small to draw definitive conclusions, comments Dr. Kaye, but patient characteristics are likely to be relevant. The patients in the Genentech trial were more heavily pretreated, and all had platinum-resistant disease. The trial investigators noted that exposure to 3 previous regimens was strongly associated with the development of gastrointestinal perforation — it was seen in 5 of 21 (23.8%) such patients, but did not occur at all in the 23 patients who had received 2 previous chemotherapy regimens.

Further Studies are Ongoing

The efficacy shown by bevacizumab in these phase 2 trials has prompted further study of the drug in ovarian cancer, and several phase 3 studies are currently in progress. Two of these studies, GOG218 and ICON 7 (conducted by the Gynecological Cancer Intergroup [GCIG]), are investigating the use of bevacizumab with standard cytotoxic therapy. The GCIG group is also investigating a related drug, the small molecule vascular endothelial growth-factor receptor inhibitor AZD 2171 (Recentin, under development by Astra Zeneca) in the ICON 6 trial.

Editorialist Dr. Kaye and most of the GOG investigators have disclosed no relevant financial relationships; however, 2 of the GOG authors and all of the investigators on the Genentech trial report receiving research funding from Genentech, and 3 of these are company employees.

J Clin Oncol. 2007; 25:5180-5186 Abstract, 5165-5171 Abstract, 5150-5152 Abstract.

Medscape Medical News © 2007 

11 round total 7 rounds of Avastin only
I was on Avastin for 11 rounds 7 of the it was just Avastin. By my Third treatment I was on all three Avastin Carbo/taxol and was in remission my numbers was down to six and stayed there for almost four months. Monday I went to see my ONC because for two months my numbers have been rising I went from 6 to 82, so I am going off the chemo because the Avastin is not working. We are all different and I pray that the Avastin will work for you. The body ache are the worst I had joint pain in all my joints and me neck hurt all the time. I have had to go on morphine to deal with the pain I am looking forward to getting off the morphine I have missed driving lol. If the pain starts jump on it right away I think I waited to long to ask for help with the pain so it took longer to get it under control.

Love, Hugs, and Prayer
Anne

whiterose said:

Thanks Anne
Thanks for your tips about Avastin. I don't know what to expect in the way of side effects. I was lucky, I didn't have much pain or side effects from carbo/taxol so I'm relatively spoiled. Or maybe I have a high tolerance for pain? Don't know. I was just tired and a little nauseous, no vomiting. The nurse said I might have joint pains and headaches, I'm assuming that I could just take Advil for that? I'm hoping that I won't have to go on a prescription painkiller. Thanks for thinking of me when you have your own battles to fight. I'm praying for you also.
Thanks again.
Sue

thanks whiterose
No matter what I am going through I will always will pray for my teal sisters all of you mean the world to me it has made this fight so much more easy. As for the pain medication don't just by pass it because it is a prescription and no over the conter. You need to do what ever make you feel the best. The Joint pain can get bad enough that it can make it hard to cary on your day. About the head ache I would not know if I had them or not I have cronic migraines so I have a head ache every day lol guess that is good because I did not notice it all. I will be praying I really do hope it works for you I don't want any one in the same spot I am right now.

Love, Hugs, and Prayers
Anne