Large Review Study Says Avastin Offers Only Modest Benefits for Metastatic Breast Cancer

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Avastin (chemical name: bevacizumab) is a targeted therapy that was approved in 2008 by the U.S. Food and Drug Administration (FDA) to be used in combination with Taxol (chemical name: paclitaxel) to treat metastatic, HER2-negative breast cancer that hadn't yet been treated with chemotherapy. On Nov. 18, 2011, the FDA announced it had removed the breast cancer indication from Avastin because the medicine has not been shown to be safe and effective for that use.

Avastin has not been removed from the market, and doctors can choose to use Avastin to treat metastatic breast cancer whether or not that particular use is officially approved by the FDA. (Avastin is still approved to treat advanced cancers of the lung, colon, and rectum.)

Metastatic breast cancer is cancer that has spread to parts of the body away from the breast, such as the bones or liver.

Results from a new large review study show that Avastin offers only modest benefits for stopping the growth and spread of metastatic breast cancer.

The study was published online on July 11, 2012 in The Cochrane Library. The Cochrane Library catalogues information from the Cochrane Collaboration, a highly respected program that helps doctors and patients decide on the best treatment approaches based on careful analysis of available research. Read the summary of “Treatments targeting blood vessels for metastatic breast cancer.”

Studies involving more than 4,000 women that looked at combining Avastin with one of several chemotherapy medicines to treat metastatic breast cancer found that the time before the cancer grew or spread (progression-free survival) increased only a little and that overall survival didn’t increase at all. This means that the women in the studies lived for about the same amount of time whether or not they got Avastin. Women who got Avastin also had more, and more serious, side effects, including heart problems, low white blood cell count, and blood clots.

Many doctors believe that the benefits of Avastin for certain women diagnosed with metastatic breast cancer are worth the risks and cost of treatment. In July 2011, a committee of experts from the National Comprehensive Cancer Network (NCCN) -- an alliance of 21 of the world’s leading cancer centers -- voted to continue to support the approval of Avastin in combination with Taxol to treat metastatic, HER2-negative breast cancer that hasn’t been treated with chemotherapy.

If you've been diagnosed with metastatic breast cancer, you and your doctor will develop a treatment plan that will likely include chemotherapy and possibly hormonal therapy and/or targeted therapy medicines. No matter which treatments are recommended for you, you may want to talk to your doctor about:

  • why each treatment is recommended (including any combinations)
  • treatment timing and sequence
  • the expected benefits, risks, and side effects of each treatment

If you're already getting Avastin and are responding to treatment, you may want to ask your doctor about the Cochrane study. It's likely that your doctor will recommend that you stick with your treatment plan unless it stops being effective or unacceptable side effects develop. If your insurance company will not cover the cost of your Avastin treatment, talk to someone on your medical team about your options for getting help to afford continuing treatment.

Genentech, the maker of Avastin, remains committed to evaluating the use of Avastin to treat metastatic breast cancer. The company plans to conduct new research focusing on identifying the women who are most likely to benefit from Avastin treatment. Stay tuned to Research News for information about any results.

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