Anti VEGF therapies
Posted 5/13/2011
Posted in
This is an editorial from the Journal of Clinical Oncology about the use of anti-VEGF therapies, usually in advanced cancer. These are the anti-angiogenesis therapies that have evolved from the seminal work of Judah Folkman, MD. The theory is that cancer cells/tumors need a blood supply in order to grow, so that, if you can make it impossible for them to develop blood vessels and access, the tumor cells will die. This editorial, for those of you who are interested in the science or for whom this may be relevant, is an excellent summary of the current state of the art. Per usual, I am giving you the introduction and then a link to read it all:
Anti-Vascular Endothelial Growth Factor Therapy
for Breast Cancer: Can We Pick the Winners?
Bryan P. Schneider and George W. Sledge Jr, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
Anti-vascular endothelial growth factor (anti-VEGF) therapy for
breast cancer has been a veritable roller coaster of results. The first
phase III trial of the monoclonal antibody bevacizumab in refractory
metastatic breast cancer failed to demonstrate a benefit for the addition
of bevacizumab to capecitabine.1 The E2100 trial in the firstline
metastatic setting, in contrast, demonstrated an impressive
doubling of progression-free survival.2 Two subsequent phase III
trials (AVADO and Ribbon-1) in the first-line setting, while demonstrating
improvements in progression-free survival, were unimpressive
overall, and none of the three showed an improvement in
overall survival.3,4 Based on these outcomes, the Oncology Drug
Advisory Committee recommended, and the US Food and Drug
Administration has agreed to, removal of the breast cancer indication
fromthebevacizumablabel.Noristhistheendofanti-VEGFtherapy
woes. Phase III trials of the small-molecule receptor tyrosine kinase inhibitor
sunitinib have failed to demonstrate therapeutic benefit in either
frist-line or refractory metastatic breast cancer (when combined with
docetaxel or capecitabine, respectively).5,6
There are several potential reasons for these trial failures.
http://tinyurl.com/4y3r7q2
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