Avastin and the Recurrence Forum

[Jatoo]

Dear Friends:

This is more for information or to exchange ideas or to learn from others:

1. Unmai was asking before re Avastin whether approved for Ovarian Cancer. "How come many people are on it?" Is anybody out there using Avastin or any antiangiogenesis drug? Definition: for cancer to grow it needs blood vessels or cells that supplies nutrients and oxygen. These blood vessels are called VEGF (Vascular endothelial growth factor) which stimulates the growth of blood vessels that nourish cancer tumors and cause them to grow. This process is called "angiogenesis". Avastin attaches to VEGF that eventually starve the cancer to death. FDA has approved the use of Avastin for Colorectal cancer.

2. Dr Goodman said, "that Ovarian cancer is initially sensitive to many different types of chemotheraphy. However when the recurrence occur with such short interval, the cancer cells that are growing back are usually the ones not killed by previous chemo. Therefore those recurrent cancer cells can be resistant to other chemo agents."

3. My wife's onc is recommending to switch from Topo to Gemzar after an elevation of CA 125 and CT scan. We asked for second opinion from an Onc who worked before in UCLA and transferred to a company who does a lot of clinical trials (24). She recommended several antiangiogenesis drugs in clinical trials and Avastin is one of them for free. So Unmai if your insurance won't cover it. You can get it here for free. We are leaning towards Avastin and we are already seeing them on Monday. They said they don't waste time.

Jatoo

[Jatoo]

Dear Lucy:

Where are you taking the trial? My wife was kicked out from it.


Thanks
Jatoo

[lucymullis]

I am participating in a clinical trial for bevacizimab. (similar to Avastin).  Is anyone else participating?

[Diane B]

Has anyone got Avasitn approved through there insurance company?  I am trying to get Avastin approved because I have been on Doxil and Topotecan for the past 10 months and nothing is working.  Also has anyone been on gemzar and cisplatin?  If so how were your results?

[unmai]

Hi Sue: Wish you a fantastic birthday! Hope this year and the years to come bring you tons of great health and happiness.  I surely keep you and everybody else in this forum in my prayers each day.
Jatoo: Thank you much for all the info.  I will surely keep that in my mind.  Hope your wife is feeling better. It surely is tough for everybody involved.  I pray that she comes out of this very soon and feel healthy and happy for years and years to come.

Last couple of weeks have been very draining.  Mom was admitted for about a week...Very low sodium!!!  During that time she also got a pig-tail catheter put in.  Now we drain that damn ascites each day at home (lots of it!). I guess I should thank god for that anyways - atleast she is able to eat little now.  Can't wait for doxil to kick in. She had her second dose yesterday.  After the first round the Ca125 went up - a lot!!!  The onc wanted to give another one for sure.  We continue to hope and pray that she feels healthy and cancer free soon.

Sue - that bday diet sounded healthy for sure :-)....

[Jatoo]

Dear Sue:

Happy Birthday. Even your birthdays are pretty close, She turned 52 last Nov. 18. She still feels okay but her tumor have grown on the pelvis very close to the gall bladder.

We haven't rule out Gemzar yet even in combination. As a matter of fact I encountered a study on Gemzar and weekly Taxol (which means lower dosage) just for platinum resistance patients and the response rate was 70% or more including some with complete response. Chaired by the same person who studied Avastin with cytoxan. Avastin on its own can stop tumors from progressing. And we have several options as to what to pick. Avastin with another antiangiogenesis drug, in combination with Oxaloplatin, or another drug which is not Avastin.

It's great to hear that your CA 125 went down. That's a good sign. Who knows we might just follow you. I just wondered how to get Tresulfan here.

Don't forget to share some of your cabbages to us here? Again Happy Birthday.

Jatoo

[sueg]

Hi jatoo,
Hows Melody feeling? I think if she has the Gemcitabine,have it with something else-it seems to work better as a combination than on its own-same with Avastin from what I've read.
I was back in hospital yesterday having my ascites drained again-feel loads better.3 litres came off and I lost 4lbs in weight-what a diet!
My second chemo is still scheduled for Monday although it will depend on my WBC that was a bit low yesterday.She's changed my anti-sickness drugs,given me a laxative to take,so hopefully this second cycle won't be as bad.My ca125 had come down by a whole 20 points-wooppeee do- 1087 to 1067-that was it-I suppose its heading in the right direction.She told me to ignore my ca125 until after the third cycle-thats when she'll know if this combo is working or not.I'm running out of prayers!!
I'm 47 on Sunday-I'm going to party all day long-Cauliflower,cabbage and broccoli birthday cake,followed by Blueberry,Carrot and Apple Juice and Ginger pudding and a glass of Carctol or Essiac tea for afters-that should cover everything shouldn't it?
Its 5am in the morning here-I can't sleep,so I'm wandering round the message boards. Give my love to Melody.
Take care you two.
Sue x

[Jatoo]

Dear Jenny:

Her's is not a randomized trial. She can pick whatever she wants. Don't give up on Doxil yet. It takes an average of 4 treatments to take it's effect. Many thanks for your concern.

Jatoo

Dear Unmai:

I will pray for your mom too and thanks for your prayers.

Jatoo

[Barney22]

Hello there jatoo - I read your comments re angiogenic inhibitors with interest having been on a short randomised trial of one earlier in the year.  I had to come off it after 12 weeks as my disease was progressing - I'm fairly sure I was on the placebo as I had no side effects at all so my assessment of the drug is probably irrelevant.  I have been on Caelyx (Doxil) for the last 2 months but have been taken off it too by my oncol as my CA125 continued rising, so I now have to make some decisions as to what comes next - like you I guess.  There is some possibility of another angiogenic inhibitor ADZ2171 which is now being trialled here in the UK (and other places) but not phase 2 (randomised) at the moment - that will start for women at an earlier stage in the disease in the Spring.  I'm not at all sure what these type of drugs can do for someone at an advanced stage - any information on that?  My oncol said they really don't know yet, so it would be a real shot in the dark for me.  I'm hoping to talk to the Prof in charge of the trial at the Royal Marsden Hospital.  The alternatives involve chemo with etoposide (oral) plus intensive doses of cisplatin over 8 weeks (3 weeks on and 1 week off for 2 cycles) then continuing on the oral etoposide.  Apparently its a very tough regime but they have had success with it in The Netherlands and have been using this method at my hospital in London for the last year.  Pretty off-putting thinking about what it will be like if I go ahead on this one in the New Year.  Avastin hasn't been approved yet for ovca here so that's not an issue as yet although I guess it will be in the near future.  Sounda a bit scary although I agree it's very difficult to make decisions on not trying it when our options are shrinking.  I'd be interested to know what you feel about angiogenic inhibitors for women who are on 3rd or more line treatments.  Good luck to your and Melody.  Jenny

[unmai]

Jenny,
Is'nt it too early to say doxil is not working....I thought they usually give it for 3-4 cycles.  May be I don't have all the info. Hopefully, somebody with more knowledge will reply soon.  I know how hard it is....hang in there.
I will keep you in my prayers.
Unmai

[Jatoo]

Dr. Goodman in the same page as answer to Unmai's question on Chemo opinion: "Another option is to consider Avastin with another agent such as cytoxan. Avastin seems very helpful in reducing ascites."