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Format: 04/20/2014
Format: 04/20/2014

News

Avastin Unsuccessful as Adjuvant Therapy in Setting of Stage II and III Colon Cancer but May Be Effective if Given for Longer Duration, AGH Oncologists Report

Wednesday, May 27th, 2009

Cancer researchers from the National Surgical Adjuvant Breast and Bowel Project (NSABP) and Allegheny General Hospital (AGH) in Pittsburgh will report today at the annual meeting of the American Society of Clinical Oncology (ASCO) in Orlando that use of the drug bevacizumab (Avastin) in combination with standard chemotherapy was not effective in prolonging disease-free survival (DFS) in patients with stage II and stage III colon cancer when given for one year. There is promise that using Avastin for periods longer than one year will lead to improved efficacy.

Approved by the U.S. Food and Drug Administration in 2004 for the treatment of metastatic colorectal cancer and subsequently for the treatment of breast and lung cancer, Avastin is a medicine that interferes with the growth of cancer cells by inhibiting the formation of new blood vessels in cancerous tumors.

According to Norman Wolmark, M.D., principal investigator and chairman of both the NSABP and AGH’s Department of Human Oncology, the study being presented at ASCO is the first to explore use of Avastin in the adjuvant setting for patients with earlier stages of colon cancer.

Between September, 2004 and October, 2005, 2,710 patients with stage II and stage III colon cancer were randomized in the prospective study to determine whether mFolfox6 + Avastin would prolong disease free survival compared to mFolfox6 alone. Disease-free survival events were defined as first recurrence, secondary primary cancer, or death.

With a median follow-up of 36 months, the researchers found that although the addition of Avastin to mFolfox6 did not result in an overall statistically significant prolongation of DFS among study participants, there was a marked transient benefit in DFS during the one year interval that Avastin was utilized in the protocol.

“In this study, we found that Avastin substantially reduced the risk of cancer recurrence, while it was being used. The challenge moving forward is to determine how the drug can be administered in the most optimal manner, with the idea and promise that prescribing it for longer durations may improve its efficacy for patients with these stages of the disease,” Dr. Wolmark said.

Colorectal cancer is the most common cancer diagnosed in the United States. The American Cancer Society estimates that there are approximately 112,340 new cases of colon cancer and 41,420 new cases of rectal cancer diagnosed annually. Combined, they will cause about 52,180 deaths.

Determining the stage of a colon cancer diagnosis is integral to choosing the most appropriate treatment, Dr. Wolmark said. Colon cancer is classified as stage II after it moves beyond the middle layers of the colon. If colon cancer is found in at least one lymph node, it is then considered to be stage III.

Surgery remains the primary treatment for colorectal cancer while chemotherapy and/or radiotherapy may also be recommended depending on the individual patient's staging and other medical factors.

The current Avastin adjuvant treatment study was conducted by the NSABP with support from the National Cancer Institute (NCI) and a grant from Genetech, Inc. Headquartered on the campus of AGH, the NSABP is a major, NCI-funded clinical trials group that coordinates the efforts of more than 6,000 physicians, nurses and other medical professionals throughout North America, Ireland, Australia and Puerto Rico in the study of breast and bowel cancer.
 

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