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pharmboy21

05/22/08 5:17 PM

#23627 RE: cjgaddy #23612

cjdaddy,

When looking at bavi efficacy, it is important to have a good understanding of the general treatment protocols and expected outcomes, for the various types of breast cancer, specifically metastatic breast cancer.

http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Breast/Management/MetastaticDisease.htm

This is a link to the BC cancer agency, largely run out of vancouver. It is one of the premier cancer treatment sites in the world, and has a great website describing every type of cancer, along with treatments and outcomes.

Metastatic breast cancer is not considered curable with currently available chemo regimens, but is generally looked upon as a means of extending life and reducing some symptoms, so it would be very unlikely that we will see anyone cured by the addition of bavi. If you look through the 1st/2nd/3rd/4th line chemo options, you'll have a good understanding of where the patients in the last trial were when they were given bavi

In the previous phase 1 trial, the patients had failed mutiple regimens of chemo, meaning that these regimens had failed to reduce or stabalize the primary tumor and had not stopped metastasis. Also, by having multipe regimens of chemo, their immune systems were likely weaker than similar patients that had received only one failed treatment protocol. In these patients, the two women treated with bavi + docetaxel had COMPLETE resolution of their primary tumors. This is nothing to laugh at, as these patients had failed all avaiable tx options. So, you can see why they chose to pursue bavi with docetaxel in Georgia, and why it appears to be their main focus. The difference with the patients in this second trial is that they have not received a taxane before, meaning their cancer has not had any opportunity to evolve in such a manner gauranteeing its ineffectiveness, and secondly, their immune systems generally should be in a stronger state, which is what bavi relies on to do its heavy lifting once it has bound to its target.

I am hoping that along with the efficacy on primary tumor response they may give us some info on whether metastasis continues to spread in these patients, or if it is largely inhibited, as in many of the animal studies. Some info on survival would be helpful, but I am not sure if that information will be available....But the big thing to keep in mind is that if bavi is having a significant effect on such resistant tumors, then it will not take long for it be used in primary treatment for women with localized disease, or recurrent disease, where the net result of complete response of the primary tumor equates to a cure...not to mention that due to its MOA it may prime the body to prevent recurrence, something current treatment options cannot lay claim to.