האם האווסטין מצילת חיים?
האם היא מרפאית את סרטן המעי?
האם היא מאריכה את חיי החולים בצורה משמעותית?
התשובה לכל 3 השאלות היא לא!
לפי מחקרים אחרונים, תוחלת החיים של חולים בגידול מעי גרורתי שטופלו בשילוב של כימותרפיה ואווסטין עלתה ב 2-5 חדשים בלבד על זו של חולים שטופלו בכימותרפיה בלבד.
Crit Rev Oncol Hematol. 2006 Apr 3;
Angiogenesis and cancer: A cross-talk between basic science and clinical trials (the ''do ut des'' paradigm).
de Castro Junior G, Puglisi F, de Azambuja E, El Saghir NS, Awada A.
Medical Oncology Clinic, Institut Jules Bordet, Brussels, Belgium.
Bevacizumab and colorectal cancer
Further evidence arises from the trials that have investigated the role of the anti-VEGF monoclonal antibody bevacizumab (rhuMAB VEGF; Avastin; Genentech Inc., South San Francisco, CA) combined with chemotherapy (CT) in metastatic colorectal cancer (MCRC, Table 2). Two phase III studies [44] and [45] and one pooled analysis [46] compared the addition of bevacizumab to chemotherapy, versus chemotherapy alone, in MCRC. The addition of bevacizumab to the IFL regimen (irinotecan/5-fluoruracil/leucovorin) showed an increase in terms of response rate (44.8% versus 34.8%, p = 0.004), progression-free survival (PFS, 10.6 months versus 6.2 months, p 0.001) and overall survival (OS, 20.3 months versus 15.6 months, p 0.001) [44]. The pooled analysis in which 5-fluoruracil/leucovorin/bevacizumab was compared to 5-fluoruracil/leucovorin also indicated significantly improved response rate (34.1% versus 24.5%, p = 0.019), PFS (8.8 months versus 5.6 months, p = 0.0001) and OS (17.9 months versus 14.6 months, p = 0.0081) in patients treated with bevacizumab [46]. More recently, the ECOG E3200 study [45] compared the FOLFOX-4 regimen (oxaliplatin/5-fluoruracil/leucovorin) to the same chemotherapy added to bevacizumab. Again, the addition of bevacizumab resulted in significant gains in response rate (21.8% versus 9.2%, p 0.0001), PFS (7.4 months versus 5.5 months, p = 0.0003) and OS (12.5 months versus 10.7 months, p = 0.0024).
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