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Sent: Wednesday, June 02, 2004 8:11 PM
Subject: Anti-angiogenic Drug extends lives of colorectal cancer patients


> >From the ACOR website
> ( http://www.acor.org/news/whatsnew.html?item_id=2139 )
>
>
> Anti-angiogenic Drug extends lives of colorectal cancer patients
>
> Published: Jun 02, 2004
>
> Promising results in Jonsson Cancer Center study
> A drug designed to cut off a tumor's blood supply, when paired with a
> chemotherapy combination, resulted in significant improvement in
> survival in patients with metastatic colorectal cancer, the first time
> in decades that survival times have been extended in patients with this
> devastating form of advanced cancer.
>
> The results of the study, done at UCLA's Jonsson Cancer Center and
> several other sites nationwide, appear June 3, 2004 in the New England
> Journal of Medicine.
>
> The study paired the angiogenesis inhibitor Avastin, approved by the
> U.S. Food and Drug Administration in February for use in colorectal
> cancer, with irinotecan, 5-fluorouracil and leucovorin. The combination
> therapy improved median survival in patients by nearly five months,
> reducing risk of death by more than 30 percent. It also improved
> response rates, duration of response and progression-free survival
> times, said Dr. Fairooz Kabbinavar, a Jonsson Cancer Center researcher
> and senior author of the study.
>
> "To put this study in the right perspective, up until the year 2000,
> median survival in patients with advanced colorectal cancer was about
> 12 months," said Kabbinavar, an associate professor of
> hematology/oncology who has been working with Avastin for the last 10
> to 12 years, both in the lab and in the clinic. "In just four short
> years, we're now looking at survivals in excess of two years. We've
> come a long way. Avastin has not only changed the way we treat
> colorectal cancer, but I believe it will become a part of cancer
> management for other tumors such as lung, breast and pancreatic
> cancers."
>
> A tumor cannot grow bigger than a pinhead unless it establishes an
> independent blood supply through a process called angiogenesis. This
> process provides the tumor with the oxygen and nutrients it needs to
> grow and spread. Researchers have theorized that by stopping or cutting
> off the new blood supply, they can starve and, hopefully, kill the
> cancer. Researchers had hoped that Avastin - a monoclonal antibody that
> targets the Vascular Endothelial Growth Factor (VEGF), a dominant
> protein that promotes growth of blood vessels - would help the
> chemotherapy work more effectively, and vice-versa, providing what is
> called a synergistic effect. Kabbinavar said the study proved there is
> such an effect.
>
> "This is an important milestone in cancer management in general and in
> colorectal cancer management in particular," Kabbinavar said. "Avastin
> is the first angiogenesis inhibitor to be approved by the FDA, and we
> found it has manageable toxicity. So patients not only live longer, but
> their quality of life is also maintained."
>
> In the study, 813 patients with previously untreated advanced
> colorectal cancer were randomly assigned to two groups. In one group,
> 402 patients received irinotecan, 5-fluorouracil and leucovorin plus
> Avastin. The other 411 patients received the chemotherapy combination
> plus a placebo. The studied looked at overall survival,
> progression-free survival, the response rate, duration of the response,
> safety and quality of life.
>
> Median survival, the time at which half of study patients are still
> alive, in the group getting Avastin with chemotherapy was 20.3 months
> compared to 15.6 months in those getting chemotherapy and a placebo,
> reducing risk of death by 34 percent. Progression-free survival, the
> time before the cancer continues to grow again, was10.6 months in the
> Avastin group compared to 6.2 months in the placebo group. Response
> rates in the Avastin group were 44.8 percent, compared to 34.8 percent
> in the placebo group. Response duration in the Avastin group was 10.4
> months, compared to 7.1 months the group getting the placebo with
> chemotherapy.
>
> "The addition of (Avastin) to 5-fluorouracil-based combination
> chemotherapy results in statistically significant and clinically
> meaningful improvement in survival among patients with metastatic
> colorectal cancer," the study states.
>
> After several disappointments with angiogenesis inhibitors, this study
> proves that targeting a tumor's blood supply is a viable treatment
> option, Kabbinavar said.
>
> According to the American Cancer Society, colorectal cancer will strike
> more than 146,000 Americans this year alone, killing about 56,730.
> Overall, colon cancers are the third most common cancers in men and
> women, and the second leading cause of cancer death in the United
> States.
>
> Source: New England Journal of Medicine