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Senior Citizen Health & Medicine
Avastin Cancer Drug Extends Survival for Patients
with Deadly Brain Tumors
Shrinks tumors by cutting off blood supply; used,
too, on lung, colorectal cancers
Feb. 20, 2007 - Avastin, a relatively new type of
drug that shrinks cancerous tumors by cutting off their blood supply,
slowed the growth of the most common and deadly form of brain cancer in
a pilot study at Duke University Medical Center. Sixty-three percent of
patients with advanced cases saw their tumors shrink by at least 50 percent in the first
12 weeks and 38 percent showed no growth at six months.
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The study marks the first time that Avastin has
been tested against brain tumors, the researchers said. The drug, whose
chemical name is bevacizumab, currently is used to treat lung and
colorectal cancers.
The researchers tested the effectiveness of Avastin
in conjunction with a standard chemotherapy agent in patients with
recurrent cancerous brain tumors called gliomas. They found that the two
drugs together halted tumor growth up to twice as long as comparative
therapies.
Though gliomas remain incurable in nearly all
cases, the combined drug therapy may buy precious time and preserve
physical and mental function longer for patients facing this grim
diagnosis, the researchers said.
"These results are exciting because of the possible
implications for a patient population that currently has the poorest
possible prognosis going into treatment, those with malignant brain
tumors that have recurred after initial treatment," said James
Vredenburgh, M.D., a brain cancer specialist at Dukes Preston Robert
Tisch Brain Tumor Center and lead researcher on the study.
The findings will appear in the Feb. 20, 2007,
issue of the journal Clinical Cancer Research. The study was funded by
the National Institutes of Health, the Preston Robert Tisch Brain Tumor
Research Fund, the Bryan Cless Research Fund and Genentech, the maker of
Avastin.
Duke currently is participating in a large,
multi-institutional study of Avastin to corroborate the results of this
initial study, Vredenburgh said.
Kate Carr, president and chief executive officer of
Accelerate Brain Cancer Cure, a not-for-profit organization that
supports research to hasten a cure for brain cancer, said, "The results
of this initial study are very encouraging and we are now excited to
learn the findings of the larger study, that, it is hoped, will lead to
an approved therapy for patients with brain cancer."
In the pilot study, the researchers found that dual
therapy with Avastin and the chemotherapy drug irinotecan either shrank
the tumors or restricted their growth in nearly all cases for up to
three months longer than comparative therapies.
Three months is a significant advance when dealing
with these aggressive tumors, Vredenburgh said; common current treatment
normally offers only six to 12 weeks of halted growth before the tumor
grows and spreads, ultimately destroying cognitive and physical function
and leading to death.
Approximately 18,000 people are diagnosed with
gliomas in the United States each year, making them the most common and
most deadly malignant tumors of the central nervous system.
Gliomas are difficult to treat because they grow
quickly and occur behind the blood-brain barrier, a natural protective
layer around the brain that prevents materials carried in the
bloodstream -- including medicines -- from reaching the brain and spinal
cord.
Life expectancy after diagnosis of a stage IV
glioma -- the most aggressive kind of the cancer -- is eight to 15
months, Vredenburgh said. Individuals diagnosed with a stage III glioma,
which is slightly less aggressive, survive 16 to 24 months on average.
When the tumor returns after initial treatment -- which usually includes
surgery, chemotherapy and radiation -- the prognosis is even more grim,
with an average life expectancy of three to nine months.
"When the tumor recurs after treatment, there are
no standard therapies," Vredenburgh said. "This study may lead to
options where there previously were none."
Avastin may be effective in treating gliomas
because these tumors have a high concentration of vascular endothelial
growth factor, a protein that stimulates development of new blood
vessels in a process known as angiogenesis. New blood vessels spur a
tumors growth and ability to spread, so researchers are interested in
cutting off angiogenesis to slow tumors down. Avastin is an
anti-angiogenesis drug that works by choking off the blood supply to
these prolific blood vessels.
"What makes these tumors so deadly might actually
be what also makes them susceptible to this exciting new therapy,"
Vredenburgh said.
The 32 patients who participated in this study had
been diagnosed with stage III or stage IV recurrent gliomas. Sixty-three
percent of the patients saw their tumors shrink by at least 50 percent
in the first 12 weeks of the study and 38 percent were progression-free
at six months, meaning their tumors had not grown, Vredenburgh said.
"Going forward, we will also explore the efficacy
of this treatment in newly diagnosed patients," he said. "Ultimately,
our hope is that this will offer a real weapon in what is now a very
limited arsenal for treating a very challenging cancer."
Other researchers who participated in the study
were Annick Desjardins, James Herndon, Jeannette Dowell, David Reardon,
Jennifer Quinn, Jeremy Rich, Sith Sathornsumetee, Sridharan Gururangan,
Melissa Wagner, Darell Bigner, Allan Friedman and Henry Friedman.
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