Avastin® Alone or with Camptosar® Effective for Recurrent Gliomas
Researchers affiliated with a US multicenter randomized trial have reported that Avastin® (bevacizumab) alone or combined with Camptosar® (irinotecan) was effective for the treatment of recurrent high-grade gliomas. The details of this study were published in the October 1, 2009 issue of the Journal of Clinical Oncology.[1]
Avastin is a humanized monoclonal antibody that is targeted against the vascular endothelial growth factor (VEGF). The U.S. Food and Drug Administration (FDA) has approved Avastin as a single agent for the treatment of glioblastoma that has progressed following prior therapy. A previous study from Duke University showed a 57% response rate for 23 patients with recurrent glioblastoma multiforme following treatment with Avastin and Camptosar. The main side effects were thromboembolic, and the regimen was described as well tolerated. Researchers from Israel have also reported that the combination of Avastin and Camptosar is an effective combination for the treatment of recurrent high-grade gliomas. However, researchers from the University of California at Los Angeles have reported that patients with recurrent glioblastoma who were treated with Avastin alone experienced a slight survival advantage compared with patients treated with Avastin plus Camptosar.
Preliminary results of this study were presented at the 2008 annual meeting of the American Society of Clinical Oncology (see third item of related news). This study randomly allocated 167 patients with recurrent glioblastoma to treatment with Avastin alone or Avastin with Camptosar. This trial was a phase II randomized study which was not designed to determine the relative effectiveness of the two regimens. The following table summarizes the main findings of this trial:
| Avastin | Avastin plus Camptosar |
Number of Patients | 85 | 82 |
Objective Response Rate | 28.2% | 37.8% |
6-month Progression-free Survival | 42.6% | 50.3% |
Median Overall Survival Time | 9.2 months | 8.7 months |
Grade 3 or Greater Adverse Events | 46.4% | 65.8% |
Neutropenia was more frequent in patients receiving Camptosar.
Comments: Although not designed as a comparative study these results suggest that Camptosar, as given in this study, contributes little to the outcome of patients receiving Avastin for recurrent glioblastoma.
Related News:
Avastin® and Radiation Therapy Safe and Active for Recurrent Gliomas (09/03/2009)
Avastin® Approved for Progressive Glioblastoma (06/24/2009)
Avastin® Improves Survival in Recurrent Brain Cancer (6/4/2008 2:03:31 PM)
Avastin® and Camptosar® Effective for Recurrent Gliomas (3/19/2008)
Reference:
[1] Friedman HS, Prados MD, Wen PY, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. Journal of Clinical Oncology 2009;27:4733-4740.
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