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ONCOLOGY Nurse Edition. Vol. 23 No. 11
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Drug Essentials 

Bevacizumab for Renal Cell Carcinoma, Glioblastoma, and Other Solid Tumors

By Gail M. Wilkes, MS, RNC | October 9, 2009
Gail M. Wilkes, MS, RNC, AOCN, is an oncology educator and nurse practitioner at Boston Medical Center, Boston, Massachusetts. She has published cancer-related books for patients and professionals, and is an author of the Oncology Nursing Drug Handbook.

Responses (based on World Health Organization [WHO] radiographic criteria) were observed in 25.9% of the patients, with a median response duration of 4.2 months.

NCI 06-C-0064E was a single-arm, single-site study of bevacizumab(Drug information on bevacizumab) for the treatment of patients with previously treated gliomas. All 56 patients had documented disease progression after receiving temozolomide(Drug information on temozolomide) and radiation therapy. Patients received bevacizumab (10 mg/kg IV) every 2 weeks until disease progression or unacceptable toxicity was noted. The objective response rate was 19.6% (using the same WHO radiologic response criteria as in AVF3708g). Median response duration was 3.9 months.

Experience with another pan-VEGF receptor inhibitor, cediranib (AZD2171, Recentin), showed that there was immediate blockade of the VEGFR pathway in many patients, but when patients relapsed, two unexpected pathways then took over, providing angiogenesis for the tumor. This suggested that, ultimately, a multidrug regimen would be required for optimal treatment.[3]

Other solid tumors
Bevacizumab is already used to treat several types of solid tumors. It was first approved by the FDA in February 2004, for use with intravenous, fluorouracil(Drug information on fluorouracil) (5-FU)-based chemotherapy to treat metastatic colorectal cancer. In October 2006, it was approved to treat unresectable locally advanced or metastatic nonsquamous, non-small-cell lung cancer (NSCLC) in combination with carboplatin(Drug information on carboplatin) and paclitaxel(Drug information on paclitaxel), and in February 2008, it was approved for use with paclitaxel for patients who have not received chemotherapy for metastatic HER2-negative breast cancer. (It is not indicated for patients whose breast cancer has progressed following anthracycline and taxane chemotherapy administered for metastatic disease.)[4]

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Financial Disclosure: The author has no significant financial interest or other relationship with the manufacturers of any products or providers of any service mentioned in this article.




 
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