The U.S. Food and Drug Administration (FDA) has expanded the approval of the drug Avastin® (bevacizumab) to include treatment of glioblastoma that has progressed following prior therapy. Avastin was already approved for selected patients with advanced breast cancer, colorectal cancer, or non–small cell lung cancer.

Primary brain cancer is cancer that originates in the brain. Glioblastoma is one of the most common and fatal types of primary brain cancer. It develops from the glial cells, which are the most abundant cells in the nervous system. Glial cells provide supportive functions that facilitate the work of neurons (cells that transmit impulses between the brain, spinal column, and nerves).

Current treatment for glioblastoma includes surgery followed by radiation and chemotherapy. However, even with the most aggressive treatment available, many patients will survive less than one year after diagnosis. As such, researchers continue to evaluate new and innovative treatment strategies such as targeted agents.

Avastin is a targeted therapy that blocks a protein known as VEGF. VEGF plays a key role in the development of new blood vessels. By blocking VEGF, Avastin deprives the cancer of nutrients and oxygen and inhibits its growth. Avastin’s effects on blood vessels may also improve the delivery of chemotherapy to the tumor.

The study that led to the approval of Avastin for glioblastoma was a Phase II clinical trial that enrolled 167 patients with glioblastoma that had progressed following initial treatment with Temodar® (temozolomide) and radiation. Study participants received treatment with Avastin alone or Avastin plus the chemotherapy drug Camptosar® (irinotecan).

  • Among the 85 patients treated with Avastin alone, 26% experienced a reduction in the extent of the cancer. Among these responding patients, the median duration of response was 4.2 months.
  • The most common side effects of treatment with Avastin were fatigue (45%), headache (37%), high blood pressure (30%), diarrhea (21%), and nose bleeds (19%).

Although these data suggest that Avastin can reduce the extent of cancer in patients with progressive glioblastoma, there is still no conclusive evidence that Avastin improves survival or reduces cancer-related symptoms. Nevertheless, the approval of Avastin for progressive glioblastoma provides these patients with another treatment option.

Reference: Roche Media Release. Important new treatment option approved in US for patients with the most aggressive form of brain cancer. Available at: Accessed May 6, 2009.

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