Dear OncoLink "Ask The Experts,"
Is there a therapeutic advantage to giving Avastin first or last in a regimen?
Bruce Giantonio, MD, Assistant Professor of Medicine in the Hematology-Oncology Division at the University of Pennsylvania, responds:
I am not aware of any clinical data that argues for one over the other, i.e. for a benefit to giving it either first or last within the treatment regimen. In the clinical trial E3200, we specified that the bevacizumab (Avastin) be given first, but that was to provide consistency and not for any other reason. However, based on the 'pseudo-normalization' hypothesis of anti-VEGF (anti-angiogenesis) therapy, it is possible that administering the bevacizumab prior to the chemotherapeutic drugs could potentially enhance delivery of the chemotherapy into the tumor.
Jun 6, 2012 - Continuing use of bevacizumab (Avastin) in combination with second-line chemotherapy improves overall survival and progression-free survival in patients with metastatic colorectal cancer who have progressed after discontinuation of first-line bevacizumab and chemotherapy, according to the results of a phase III study presented at the annual meeting of the American Society of Clinical Oncology, held from June 1 to 5 in Chicago.
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