Avastin question

[twinmom]

Hi everyone, I'm new here, so not sure if this is the right place to post this question. Please let me know if there's a better place!

As I mentioned in my intro, I was diagnosed this week w/adenocarcinoma, spread to my lymph nodes, bones, liver and a teeny bit in my brain.

The plan was to use carboplatin and taxol, and hopefully avastin (pending MRI results). Now the results are in, and there's a little there, but much less than they usually see. Now there is debate among the oncologists as to whether it is safe to use the avastin. I guess normally they won't if it's metastasized to the brain, but since it is a smaller amt than usual, it's open for discussion. I guess there is a .5 cm brain lesion and 2-3 tinier spots they're not sure about.

Has anyone used avastin in this situation? Or know anything more about it? My husband has been doing a lot of research and is tempted to push for it but I'd love to hear any of your experiences or knowledge.

Thanks, and I apologize for not being up on correct terminology. I've only been at this a few days now.

Beth

[DrWest]

Beth,

As someone who has been very familiar with Avastin's development in lung cancer and the questions about using it in patients with brain mets, I think your doctors debating the issue is right on target. The fact is that there is no wide experience of using avastin in patients with brain metastases, since the key trials of Avastin in lung cancer did not permit such patients to enroll, out of concern that they would be at higher risk for a bleeding problem in the brain (that's BAD).

There have definitely been patients with brain metastases, most of whom having already received brain radiation to treat the mets, who received Avastin and did fine. But there were also a few patients who have had bleeds in the brain, in situations in which an unsuspected brain met emerged after the initial screening scan. There are a growing number of studies in which avastin is being tested in potentially higher-risk situations like brain metastases and radiated squamous cell cancers, but the key question is whether you want to venture out onto thinner ice than what we have established is generally safe. It might be safe and often is for patients with brain metastases, but it would be awful to be wrong.

-Dr. West

[Adrian]

fyi, my dad next week begins a clinical trial called "Passport" specifically focusing on the use of avastin as first or second line treatment in stage IV NSCLC patients with treated brain metastasis. Its a Phase II trial.