just read a rodman analyt report today as well, saying how avastin trends, projected sales downgrades.
thoughts? will avastin still be the key oncology blockbuster in the next couple of years??
i've been hearing good and bad news about their C-08 trial (adjuvant CRC).
15:42 Genentech’s Avastin unlikely to show survival benefit in patients with metastatic melanoma, physicians said
Story Genentech Avastin's mechanism of action may not alter disease outcomes for patients with metastatic melanoma, physicians said. Avastin's target – vascular endothelial growth factor (VEGF) – may not play a significant role in the disease pathology, they said.
Yet the drugs being combined with Avastin (bevacizumab) in the ongoing clinical study – carboplatin and Taxol (paclitaxel) - will likely be approved as the next combination therapy for metastatic melanoma, they added.
Genentech could not be reached for comment.
Avastin is a monoclonal antibody against VEGF which inhibits tumor growth by preventing angiogenesis, or blood vessel formation, essentially starving tumors. The drug is approved for the treatment of metastatic colorectal cancer, non-small cell lung cancer and metastatic breast cancer.
Avastin is not the ideal drug to study in metastatic melanoma because the anti-angiogenic mechanism does not play a prominent role in the disease, according to Dr Antonio Ribas, an oncologist at the University of California at Los Angeles.
"Avastin seems to have done many things right in many cancers, but [VEGF] is not a key event that we are blocking in metastatic melanoma," Ribas said.
Although VEGF is an attractive target, there is a lack of evidence in metastatic melanoma that acting on it will have an impact, said Dr John Kirkwood, an oncologist and vice chairman for clinical research at the University of Pittsburgh School of Medicine. Although angiogenesis plays a role in melanoma, it is not as prominent as in other cancer types, Kirkwood added.
Drugs that target VEGF have not historically had positive results in treating patients with metastatic melanoma, noted Dr Theodore Logan, an oncologist at the Simon Cancer Center at Indiana University. Bayer AG's Nexavar – which also against VEGF – recently showed no activity in its phase III PRISM trial.
Dr David McDermott, an oncologist at Beth Israel Deaconess Medical Center in Boston, said that ongoing Avastin studies are currently excluding patients with elevated HDL levels, who have a poorer disease prognosis. Companies such as Medarex have also adopted this approach in their trials of ipilimumab, as stratifying patients in this manner might reveal a sub-group benefit, McDermott noted.
Physicians are not overly optimistic about Avastin's prospects to treat patients with metastatic disease, as every drug "with a glimmer of hope" has ended up failing during the past 15 years, Kirkwood said. Avastin is also undergoing clinical trials in the adjuvant setting, in a trial known as the CRUC study, he added.
Still, even if Avastin fails to benefit this patient population, the drug is being used as a part of a cocktail therapy that is likely to stick around, Ribas noted. Currently, Avastin is being studied in combination with carboplatin and paclitaxel, he explained. Approximately 17% of patients respond to carboplatin and paclitaxel, he added.
"The reality is that the carboplatin and paclitaxel works in a significant number of patients with melanoma," Ribas said.
Kirkwood agreed that the carboplatin and Taxol combination regimen is likely the next combination to be approved for metastatic melanoma.
Progression free survival is being measured as a primary endpoint in an ongoing phase II multicenter, randomized, double-blind, placebo-controlled trial. The study is examining the efficacy and safety of bevacizumab in combination with carboplatin and paclitaxel chemotherapy for the first-line treatment of patients with metastatic melanoma.
by Klara Czobor and Beth Herskovits in New York
Source Pharmawire
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