Bevacizumab (Avastin)
| Property | Information |
|---|---|
| Drug Name | Bevacizumab (Avastin) |
| Overview | Bevacizumab, sold under the brand name Avastin, is a monoclonal antibody that inhibits vascular endothelial growth factor (VEGF). By targeting VEGF, Avastin reduces the blood supply to tumors, which can slow their growth. It is FDA-approved for the treatment of recurrent glioblastoma and is often combined with other therapies to manage this aggressive cancer. |
| FDA Approval | Yes, for recurrent glioblastoma |
| Used for | Management of recurrent glioblastoma and investigational use in newly diagnosed glioblastoma as part of combination therapies |
| Clinical Trial Phase | Phase III for glioblastoma |
| Clinical Trial Explanation | Not specified |
| Common Side Effects | Hypertension, proteinuria, hemorrhage, gastrointestinal perforation, thromboembolic events, and wound healing complications |
| OS without | AVAglio trial: 16.7 months; RTOG trial: 16.1 months |
| OS with | AVAglio trial: 16.8 months; RTOG trial: 15.7 months |
| PFS without | AVAglio trial: 6.2 months; RTOG trial: 7.3 months |
| PFS with | AVAglio trial: 10.6 months; RTOG trial: 10 months |
| Usefulness Rating | 4 |
| Usefulness Explanation | Not specified |
| Toxicity Level | 3 |
| Toxicity Explanation | Bevacizumab has a moderate toxicity profile. While it can extend progression-free survival and improve quality of life in glioblastoma patients, it can cause significant side effects. These include hypertension, proteinuria, bleeding, and rare but severe complications like gastrointestinal perforation and thromboembolic events. Regular monitoring and management of side effects are essential during treatment. |
Notes: Bevacizumab has shown efficacy in improving progression-free survival in glioblastoma patients but does not significantly extend overall survival when compared to its use at recurrence. Its use is associated with better quality of life and delayed progression of symptoms. However, careful monitoring for adverse effects is necessary.
Avastin in Clinical Trials
Two large randomized Phase III trials, AVAglio and RTOG, evaluated the addition of Bevacizumab to the Stupp protocol for newly diagnosed glioblastoma. In the AVAglio trial, median progression-free survival (PFS) was significantly longer for patients receiving Avastin (10.6 months) compared to the control group (6.2 months). However, overall survival (OS) was not significantly different (16.8 months vs. 16.7 months). Similarly, the RTOG trial reported a median PFS of 10 months for the Avastin group versus 7.3 months for the control group, with OS of 15.7 months for the Avastin group and 16.1 months for the control.
Quality of Life and Progression-Free Survival
Both trials highlighted that while Avastin does not improve overall survival when administered as part of initial treatment, it can delay tumor progression and potentially improve the quality of life for patients. Notably, many control group patients received Avastin after tumor progression, making these studies a comparison of early versus delayed use of the drug.
Future Research and Combinations
Ongoing studies are exploring combinations of Bevacizumab with other agents, including targeted therapies, immunotherapies, and radiosensitizers, to enhance its efficacy. These efforts aim to optimize the therapeutic window and potentially improve overall survival for glioblastoma patients.<ref>Template:Cite web</ref>
From Ben Williams Book: Not specified
