avastin first line

[sdj42]

Recently diagnosed with stage IIIc ovarina cancer and my doctor wants to try Avastin with my chemotherapy as part of clinical trial.
This would start with my initial treatments and to be honest I don't know what would be best. Is this a good course of treatment to start with or should I stay with what is known to be?

[mb16]

Sorry, forgot to mention how expensive the drug is and that it's very hard to get insurance to cover it too as Dr. Goodman mentioned. I'm hoping that if the trials prove it effective for 1st line, it will be available to everyone with OVCA as an option. Teresa is probably right that you can get it added if you ask for it though as there were a few posts in the last few months of some people getting it covered under insurance.

Wendy

[westajul]

One of the drugs in my chemo combo was Avastin. My OVCA is a little unusual so I was not give carb/taxol in combination with avastin...I was given oxilaplatin...5-fu...avastin and leucovorin. This chemo combination  is usually used for colon cancer but my OVCA acted more like colon cancer than ovca. I had little side effects with Avastin and my last ct scan showed the tumors in my liver were gone...so it worked. I really hope you get into the trial group with avastin but for some taxol/carbo combination works. I just pray that what ever chemo combo you get...works. Also  I was lucky my insurance co. agreed to pay for Avastin.  Good luck and let us know how you are doing. Julie

[Annekathryn Goodman, M.D.]

Hi There,
avastin is definitely being looked at very closely in therapy for ovarian cancer. Back in 2006-2007 there were several preliminary reports about avastin.  These studies suggested that there was response to avastin for women with recurrent ovarian cancer.

The current clinical trials that compare avastin with taxol and carbo versus taxol and carbo alone are very important.  avastin is a breathtakingly expensive drug.  Many institutions and insurers cannot afford avastin off of a clinical trial.  It will be good to hopefully get solid evidence from the current clinical trials in favor of avastin. Then we can strongly advocate for this drug off trial.

There is an interesting New York times article that summarizes this dilemma

http://www.nytimes.com/2008/07/06/health/06avastin.html?_r=2&ref=health&oref=slogin

best wishes

[Teresa222]

You don't have to be in a Trial now to get Avastin. I would have the doctor add it to the first line treatment so that you KNOW you are getting it.
Teresa

[marie3B]

I agree with Wendy that the extra monitoring and testing involved with being in a clinical trial is a benefit.  The more closely we are watched, the more likely a problem would be found early.  Marie

[mb16]

I believe I'm on the same trial but I'm in Toronto. I am stage 2c. I got placed into the placebo group but really wanted to get the Avastin group so I'm crossing my fingers the Carbo/Taxol will do the trick as it seems Avastin will probably become a first line drug in the future. I figured since I'm doing chemo anyways, might as well give it everything they've got. I've just finished up my chemo as of 2 weeks ago and am estatic as I had a really tough time with it, but everyone is different and they gave me a lot of advice on this forum which helped. My doctor did warn me of side effects of Avastin too (ie bowel perforation) but told me that the risk was quite low for ovarian patients as it was given to people with colon cancer as a first line drug so most of the listed side effects were on people who were susceptible already. Good luck with whatever you decide. I enrolled in the study and let them/fate decide my treatment since the placebo is the standard first line treatment already. Another good thing about enrolling in the study (in my opinion) is that they have to monitor me more closely throughout and afterwards as part of the protocol of the study vs if I weren't in it. Yes, there is more testing involved but I think it's worth it and it also lets me do my part for research to help them fight this disease.

Wendy

[marie3B]

I know how hard it is to make these decisions.  I wasn't given a choice with my first-line treatment.  I just woke up from surgery with an I/P pump installed in my body.  Then I was sent to the onc of my gyn's chosing and she told me I would have Taxol and Cisplatin I/V & I/P.  It would have been so hard for me to make the decision on my own.  For the second-line treatment I had an advantage.  I met someone here on the forum with the same cell type of cancer that I have.  She has had great response to a chemo combination.  Since my cancer is more rare and is chemo resistant I opted to try to get the same combo that worked for her.  It does make a difference what tumor type of ovca is present.  They tend to treat all the same for first-line treatment usually.  Some kinds respond to certain chemos better than others.  It pays to learn as much as you can about your specific kind of tumor and look for studies on what may be best for second-line treatment.  I hope things go well for you.  Marie

[sdj42]

Thank you for your response. I don't know if I will have avastin or will be in the placebo group all I really know is that my doctor is recommending this trial and since all of this is new to me I am trying to learn all I can.

[marie3B]

I was not able to get Avastin as first-line treatment.  I am on it now to try to treat my first recurrence.  Since it is a clinical trial would you get the Avastin for sure, or could you be in the placebo group?  I think if it were me I would go for the Avastin with the Carbo & Taxol standard.  Your doctor must feel it will be of benefit.  Whatever you decide, I wish you the best.  I am always sad to hear of yet one more of us diagnosed with this disease.  Many do very well, and I sure hope you get a full remission. Marie