Lung cancer patients often develop metastases (cancer that has spread) in their bones or brain. A retrospective study of non-small cell lung cancer (NSCLC) patients with metastases revealed that in 39%, the cancer spread affected the bones, and in 30% the spread affected the brain. Bone metastases were more common in elderly patients, were linked to skeletal complications, such as fractures, and were associated with shorter survival (5.5 months vs 9.9 months in patients without bone metastases). Another study found that NSCLC patients who developed new bone metastases were more likely to get brain metastases also. However, patients treated with bevacizumab (Avastin) were less prone to metastases in either the bones (27% vs 43% without Avastin) or the brain (25% vs 33%).
AVAPERL evaluated the safety and efficacy of bevacizumab with or without pemetrexed as continuation maintenance treatment. In an unselected population of patients with nonsquamous NSCLC who had achieved disease control with platinum-based chemotherapy plus bevacizumab, bevacizumab plus pemetrexed maintenance was associated with a significant PFS benefit compared with bevacizumab alone. The combination was well tolerated.
Both pemetrexed (Alimta) plus carboplatin (Paraplatin) and Paraplatin plus paclitaxel (Taxol/Abraxane) plus bevacizumab (Avastin) are effective chemotherapy regimens against non-small cell lung cancer (NSCLC). However, until recently, the safety and efficacy of the two regimens had not been directly compared. To evaluate whether one regimen was superior, a phase III clinical trial determined how long patients with advanced non-squamous NSCLC remained free of either cancer progression or severe toxic side effects when treated with either of the two regimens. While patients receiving the Alimta plus Paraplatin regimen tended to have slightly longer relapse- and toxicity-free periods than those given Paraplatin plus Taxol/Abraxane plus Avastin, the difference was not very pronounced and could have happened by chance. The two regimens also did not differ regarding overall time until cancer progression, response rate and overall survival time.
A small phase I study combining the immune checkpoint antibody ipilimumab with the angiogenesis inhibitor antibody bevacizumab showed promising results in advanced melanoma patients in 2011. Now, researchers are continuing to study the combination of immunotherapy and anti-angiogenic agents to understand which patients could best benefit from such a combination. Continue reading…
“A CTEP-sponsored phase II trial was performed to evaluate safety and clinical activity of combination therapy with CCI-779 (temsirolimus) and bevacizumab in patients with advanced melanoma…”
Variations in two genes called CXCR-2 and PAR-1 may predict how a person with non-small cell lung cancer (NSCLC) will fare. A study of over 200 NSCLC patients found that those with certain versions of the genes were likely to experience faster disease progression and shorter survival, especially if patients had squamous cell carcinoma (SCC). Both genes are involved in tumor angiogenesis, that is, the growth of new blood vessels that enable tumors to expand. In the future, testing for these high-risk gene variants may help identify good candidates for anti-angiogenesis treatments like bevacizumab (Avastin).
Biothera has completed patient enrollment in a second phase II clinical trial testing a drug called Imprime PGG against non-small cell lung cancer (NSCLC). Imprime PGG redirects the immune system to attack the cancer. The drug also enhances the effectiveness of antibody drugs (drugs in the form of a type of immune system protein) like bevacizumab (Avastin) or cetuximab (Erbitux). The current phase II trial will compare NSCLC patients receiving Imprime PGG in combination with Avastin and chemotherapy to those receiving only Avastin and chemotherapy. Another ongoing phase II trial uses a similar design, but with Erbitux instead of Avastin, and has produced promising preliminary results.