Avastin work in Colon Cancer? NO

It’s too bad but as more data becomes available it’s apparent that Avastin (bevacizumab) has very limited efficacy — dispite it’s mega price.

A few weeks ago the FDA began a review of the drug in breast cancer, new studies and reanalysis of older ones showed no survival benefit. Now in regard to colon cancer in the adjuvant setting (preventing recurrence after surgery):

A combination of Avastin and chemotherapy given immediately after surgery didn’t extend disease-free survival compared with chemotherapy alone, Basel, Switzerland-based Roche said today in a statement. Preliminary data from the study suggest that chemotherapy alone is more effective in treating the tumors, Roche said.

It’s remarkable that anyone would suggest using such an expensive drug in such a setting. Consider that those who have Duke’s 3 colon cancer–the stage for which adjuvant treatment is indicated– have about a 35-40% chance of recurrence. That means 60-65% of these patients have no risk. It’s hardly cost effective to use this drug in people with no risk. This is particularly so for a drug that has shown only limited efficacy in advanced disease.

In an Eastern Cooperative Oncology Group trial (ECOG 3200),[11] the use of bevacizumab with FOLFOX in second-line treatment of metastatic colon cancer resulted in significantly improved PFS (7.3 months vs 4.7 months) and median survival (12.9 vs 10.8 months) compared with FOLFOX alone. Based on these results, bevacizumab was approved for second-line use in metastatic colorectal cancer.

Medicynical Note: As noted previously value in medicine is an oxymoron. No one is cost sensitive and just a whiff of efficacy is considered adequate reason to spend tens of thousands of dollars. In this case, there is an odor and it isn’t a just a whiff.

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