1. My son (6 years old) received Avastin along with a radiolabelled antibody last fall for stage IV relapsed neuroblastoma. He and the other kids on the study were either stable or progressed on it.

He had some side effects from the Avastin, which included high blood pressure and very serious nosebleeds. The nosebleeds were so bad his eyes would even bleed.

So - it was not a success for him. We were glad to have a chance to at least try it though as he was out of treatment options. He is now terminal and on hospice.

Posted at 2:32PM on Jul 12th 2007 by Susan

2. Susan, I am so sorry. My heart goes out to you and your family. It just doesn't seem right.
jan

Posted at 7:46PM on Jul 12th 2007 by jan

3. Lee Newcomer, former chief medical officer and currently an executive with United Health Group, stated at the 12th annual conference of the National Comprehensive Cancer Network, that “Avastin improves outcomes in about 20% of patients, but we have no idea which cancer patients will benefit from a course of treatment. Because Avastin is included with numerous drug cocktails, it costs $354,000 per year of life extended with Avastin because of today’s ‘cookie-cutter’ approach to chemotherapy. You don’t know in advance who is going to respond.”

Everyone is scared to death (and rightly so) at what is going to happen to the healthcare economic system with the introduction of increasingly expensive new drugs that benefit only a small percentage of patients who receive them, hence the headlong rush to develop tests to identify molecular predisposing mechanisms whose presence still does not guarantee that a drug will be effective for an individual patient. Nor can they, for any patient or even large group of patients, discriminate the potential for clinical activity among different agents of the same class.

Profit is a powerful motivating force. Among medical benefit payors, the profit motive is entirely consistent with the goal of developing a molecular test, which is to identify efficacious therapies irrespective of drug mark-up rates.

The FDA finds themselves under increasing pressure to allow new drugs into the marketplace, while at the same time protecting the safety of potential recipients of those drugs and also the financial interests of those who will have to pay for them. The pressure is so great that companion molecular diagnostics approved often have been mostly or totally ineffective at identifying clinical responders (durable and otherwise) to the various therapies.

It should be in the FDA’s interest in saving the healthcare system perhaps billions of dollars a year (and thereby the healthcare system itself) by ensuring that expensive treatments are used appropriately. It should serve their interest not only in discovering new cancer treatments, but also using currently-available cell culture technologies to improve the effectiveness of existing drugs and save lives today by administering the right drug to the right patient at the right time.

The methods of cancer medicine during the last thirty some years are coming to haunt the “one-size-fits-all” establishment. Technologies, developed over the last twenty years by private researchers, hold the key to solving some of the problems confronting a healthcare system that is seeking ways to best allocate available resources while accomplishing the critical task of matching individual patients with the treatments most likely to benefit them.

Posted at 4:20PM on Jul 14th 2007 by Gregory D. Pawelski