The controversy over breast cancer drug Avastin

In February 2008, the U.S. Food and Drug Administration (FDA) approved drug Avastin (Avastin) for the treatment of advanced breast cancer. Advanced breast cancer means the cancer cells have spread to other organs, such as lung, liver, or bone of breast cancer. FDA approval was letting some people be surprised to some extent, but also for other groups of people have expectations, however, FDA decided that an advisory committee in December recommended the approval of the authorities to withdraw the drug, although the opposite view nor less, the voting result is 5:4.

So What is Avastin? It in some breast cancer patients, what effect?

Avastin is a class known as anti-angiogenesis agents or angiogenesis inhibitors, new drugs in kind. Their mechanism of action is to cut off the blood supply to tumor tissue, thereby inhibiting tumor growth. Prior to this, Avastin has been approved for the treatment of colorectal cancer and lung cancer.

A large, in advanced breast cancer patients has been conducted multi-center clinical trial showed that Avastin can not only reduce the volume of tumor tissue, but also to patients with life expectancy. In this experiment, it was found that Avastin combined with standard chemotherapy drug paclitaxel in patients with longer life expectancy can nearly double (11.3 months and 5.8 months, compared with paclitaxel alone). Another one published in June this year, the results also came to similar results.

However, in cancer experts, both in the most important point, namely, the overall survival time, there is no difference. Use this indicator to measure a result, the overall survival of women taking Avastin time and not higher than single women taking Taxol long, which is why the FDA approved the drug in February for the treatment of advanced breast cancer was surprised when the reasons for the .

“We are as much as possible to act in accordance with scientific and evidence, if there is any benefit to give patients the possibility, we will strive to try,” New York University Cancer Institute, Cancer Center director Yelena. Said.

Quality of life and length of life

Eric. Wingler that Avastin for women with advanced breast cancer is a very important drug, Wingler is located in the famous Boston Dana-Farber Cancer Institute Cancer Center breast cancer women’s project department director. “In fact, cancer does not progress, or non-survival for patients is very important,” he said, “the tumor into the control of a state of life is apparently a quality of life, if you do not spend a lot of energy and financial resources in the treatment of complications, the will be able to control the tumor, which is undoubtedly the best. ”

Avastin’s side effects are not uncommon, including:

High blood pressure.

Blood viscosity, thrombosis.

Cardiac complications.

Intestinal perforation.

Proteinuria (urine protein content increased, signs of kidney dysfunction).

“For many patients, no matter what kind of complications occurred in the above-mentioned results are frightening, it is very clear,” Yelena said, “We pay particular attention to thrombosis and other vascular events, because it means that stroke. Though rare, but serious consequences. ”

However, these side effects were compared with other chemotherapy drugs for the purposes of. For many women, Avastin was well tolerated, the United States, John. Hopkins School of Medicine Breast Center, a registered nurse Lillie Shochney said, “is in advanced breast cancer patients should not only consider the quality of life issues, but also concerned about the length of life issues, I am currently nursing a patient the use of Avastin, she can continue to work, which is very important for her because she was single, lived alone, need something to support her to live. some Treatment can help people defeat to let you stay at home apart from outside can not do anything. ”

Blocking barriers to breast cancer treatment Avastin, and what is

With regard to Avastin, there is no one knows what his fate would be. “If we can accurately identify people to adapt it to come out like a matter of fact, those who responded to Avastin in patients with life expectancy extended a lot,” Wingler said, “We need better ways to Forecast for Avastin in patients with toxicity and efficacy of response:.

However, the comments of people Avastin, unlike the early breast cancer treatment Herceptin, there is no agreed conclusions. In major cancer centers, such as the Dana-Farber, New York University Cancer Center, John. Hopkins School of Medicine Cancer Center, doctors are still open for patients with advanced breast cancer drug in the kitchen, usually combined with paclitaxel — – Like that, like large-scale clinical trials.

“Not every women are suitable for Avastin,” Wingler said, “For example, if the patient can use Capecitabine, this drug like Taxol, does not cause hair loss, I will not give her open avas Ding. But in our research, many patients will accept, including Avastin combined with chemotherapy. ”

In addition, it is now also a large-scale clinical trials — on whether Avastin can be used in early breast cancer — in progress. The trial recruited 1,800 people, require a total of 5,000 people. Test will be divided into two groups, one group of the use of Avastin, another group was given placebo and early breast cancer with standard chemotherapy drugs. However, test results need to be known until a few years.

“We need to know all the circumstances of Avastin, but at present there is no answer,” Yelena said.