Therapy Finder Advisor
Section Chief, Gastrointestinal Oncology Chair,
OSUCCC Gastrointestinal Disease Research Group,
Associate Professor of Medicine and Pharmacology,
The Ohio State University – James Cancer Hospital
Avastin (bevacizumab) targets VEGF-A, a growth factor protein that functions in pathways important for new blood vessel growth thereby functioning as an anti-angiogenesis drug.
A number of benefits have been reported for the use Avastin in advanced colorectal cancer. Data from a study of patients with metastatic colorectal cancer receiving first-line Avastin or Erbitux plus chemotherapy found that progression free survival was higher for Avastin-containing combinations (Vargas CA, et al. 2014). Clinical studies have additionally demonstrated that overall survival and progression free survival are improved with continuation of Avastin plus chemotherapy after first-line progression (Michalaki V, et al. 2014, Ocvirk J, et al. 2014, Arnold D, et al. 2012).
A retrospective study reported significantly longer overall survival and progression free survival in patients with KRAS wild type colorectal cancer compared to KRAS-mutant colorectal cancer treated with Avastin (Petrelli F, et al. 2013). Other studies however, have found no association between KRAS mutation status and outcome measures in Avastin-treated colorectal cancer patients (Loupakis, et al. 2014, Kim ST, et al. 2014, Kubicka S, et al. 2013, Selcukbiricik F, et al. 2013). A trend toward larger benefit for patients with BRAF-mutant colorectal cancer treated with Avastin plus FOLFOXIRI was observed though limited by small subgroup size (Loupakis, et al. 2014).
Common side effects include epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain and exfoliative dermatitis. Less common but serious side effects include gastrointestinal perforation, wound healing complications, and severe or fatal hemorrhage (see the FDA drug label).
Avastin is FDA approved for metastatic colorectal cancer with intravenous 5-FU based chemotherapy for first- or second line treatment, including for patients who have progressed on a first-line Avastin-containing regimen (see the FDA drug label). Additionally, ongoing clinical trials are testing the safety and efficacy of other Avastin containing combinations. See the trials table.
|Avastin, bevacizumab||VEGFA||Genentech||FDA approved for: Glioblastoma Multiforme, Colorectal Cancer, Renal Cell Carcinoma, Non-Small Cell Lung Cancer|
Dear Therapy Finder® User:
During the past two years we have witnessed an unprecedented upswing in research activity leading to the identification of increasing numbers of actionable biomarkers and several effective targeted treatments. To accommodate this dramatic increase in the number of relevant biomarkers, their interactions, and other patient attributes, we are developing a new application design, one that will be both easier to use and more relevant to practicing physicians and patients. This new system will unify many of the best features and key learnings from the Therapy Finders with those from our Genomic Variant Annotation™ (GVA) reporting system.
Until we complete the redesign of our Therapy Finders or offer substitute decision-support products, we are suspending the updating of the Therapy Finders appearing on the CollabRx website and other sites.
If you click through and decide to use the Colon Cancer, Lung Cancer, Melanoma or Metastatic Breast Cancer Therapy Finders, please do so with caution, as some of the data have not been updated since October 15, 2014.
July 6, 2015