To Al , Joe , or anyone with info on Avastin trial

[Amy]

Hi everyone,
If any of you could please let me know where I can find information that will support the use of Avastin in her2 BC....I would really appreciate it.
There was a posting about a month or so ago that Al and Joe both responded to reagarding this subject. My Onc has spoke with a rep from the makers of Avastin and it was indicated that Avastin was not beneficial to BC???? So, of course she is steering me away from it.
Al, you said that the majority of those tested were not her2+++, but that maybe the her2 +++ folks had better response??? If you could please let me know where I can find this info and give it to my Onc...that would be great.
Thanks for your help.....Amy

[al from Canada]

Amy,

Joe and I have discussed this very issue 2 days ago and we are attempting to tyrack-down data. The biggest trial so far has been the avastin / taxol (E-2100) trial by Dr Kathy Miller. I'm nor sure where all this information is comming from in terms of avastin not working in BC patients BUT, here is the scoop:

Roche and Genentech announced on Friday that a phase III study (E2100) of Avastin (bevacizumab) plus paclitaxel chemotherapy in first-line metastatic breast cancer met its primary efficacy endpoint of improving progression-free survival (PFS), compared to chemotherapy alone. Results from an interim analysis of this study showed that patients receiving Avastin plus paclitaxel doubled the duration of surviving without cancer progression compared to paclitaxel alone (or a hazard ratio of 0.50, which is equivalent to a 50 percent reduction in the risk of cancer progression). Median progression-free survival was 11 months for patients treated with Avastin plus chemotherapy, compared to six months for patients treated with chemotherapy alone. At this interim analysis, a 49 percent improvement in the secondary endpoint of overall survival (or a hazard ratio of 0.67, which is the equivalent of a 33 percent reduction in the risk of death) was observed. Survival data continue to mature. In patients with measurable disease, the overall response rate was 28 percent (93/330) in the Avastin plus chemotherapy arm, a 100 percent increase over the 14 percent (45/316) observed in the chemotherapy alone arm.

Now there was information presented at SABCS that we are not privey to YET however, will try to find it.

I hope this has answered your question. It is possible to get Avastin off-label, as It is approved for CRC.

Regards,
Al

[Joe]

Avastin (bevacizumab) and Herceptin (Trastuzumab) have only completed phase I clinical trials. Dr. Mark Pegram of the Jonnson Cancer Center is currently conducting phase II trials of the combination.

I managed to "Google" the following:


Trials combining bevacizumab and trastuzumab
When we launched E2100, literally no data existed concerning the use of combination monoclonal antibody therapy in patients with breast cancer for any antibody, let alone bevacizumab and trastuzumab. Since that time, Mark Pegram and his colleagues at UCLA, based on some wonderful preclinical work, combined bevacizumab and trastuzumab in a Phase I trial that was recently reported (Pegram 2004), and they now have an ongoing Phase II trial.

The Phase I trial enrolled a total of nine patients because the combination was fairly nontoxic, and the trial zipped through the dose levels. Five of the nine patients receiving bevacizumab and trastuzumab had an objective response, and other patients had prolonged stabilization of their disease (Pegram 2004). You don’t want to make too much of a Phase I trial or a trial with nine patients, but for a treatment with no chemotherapy involved, this is a respectable response rate. If bevacizumab plus trastuzumab plays out in the larger Phase II trial, it will be a felicitous combination.

[jhandley]

Hi all

When I went to Dennis Slamon's lecture in Australia on herceptin in Nov 2004 he was saying that the next thing they wanted to try was avastin and herceptin, as it looked like being an excellent combo. from the science point of view.

cheers
Jackie

[al from Canada]

That bit of news was based on molecular profiling that indicated that of all HER2 +++ patients, 75% of them will also have VEGF Overexpression.

Al