Avastin Improves Quality of Life for Mesothelioma Patients

A research team from France has documented the health-related quality-of-life benefits of adding Avastin (bevacizumab) to chemotherapy for pleural mesothelioma patients, endorsing its addition to standard-of-care treatment.

The recent quality-of-life analysis was a secondary endpoint of an earlier, multicenter clinical trial in France that showed an almost three-month median survival improvement when adding Avastin.

The latest study demonstrated that adding Avastin to cisplatin and Alimta (pemetrexed) did not negatively impact quality of life — a problem with several other cancers because of the increased toxicity.

“Contrasting results of health-related quality of life have been reported with the combination in different types of tumors,” Dr. Virginie Westeel, co-author and head of thoracic oncology at University Hospital in Besancon, France, told The Mesothelioma Center at Asbestos.com. “Therefore, it was really important to be specifically verified in malignant pleural mesothelioma. Patients should be aware of the findings.”

Clinical Cancer Research published the study in June 2019.

Avastin Helped Reduce Pain

The authors reported that the addition of Avastin improved quality-of-life measures specifically for peripheral neuropathy and pain dimension.

With peripheral neuropathy, the deterioration-free survival time jumped from 7.6 months to more than a year by adding Avastin.

With the pain dimension, deterioration-free survival time went from 9.8 months to nearly a year with Avastin.

“Bevacizumab [Avastin] can certainly play a role in the treatment of this disease,” Westeel said. “Quality-of-life analyses are of utmost importance. They add the vision of the patient and not only that of the oncologist to the trial results.”

Standard-of-care treatment for pleural mesothelioma in France already includes Avastin, which also is recommended by the U.S.-based National Comprehensive Cancer Network.

The U.S. Food and Drug Administration, though, has not approved it yet for mesothelioma, at least partially because of the difficult side effects it creates with some cancers.

Previous studies with ovarian cancer, for example, showed increased survival time when combined with standard chemotherapy but also showed a significant decrease in quality of life.

In some cancers, it can cause blood clots in the lungs, holes in the stomach lining, hemorrhaging and low white blood cell count.

One earlier study showed patients taking Avastin with chemotherapy were 1.5 times more likely to die because of treatment complications than those taking only chemotherapy.

Avastin Slows Tumor Growth

Avastin is considered an angiogenesis drug.

It works by inhibiting a specific protein that stimulates the formation of new blood vessels, effectively slowing the growth of cancer cells. It also works best in conjunction with chemotherapy.

The high cost of Avastin, though, has restricted its use and slowed the approval process.

The National Comprehensive Cancer Network, which includes 30 leading cancer centers in the U.S., first recommended it in 2017. Their recommendations often serve as a precursor to FDA approval.

“The addition of a third drug [Avastin] can logically add treatment-related adverse events,” Westeel said. “But these new adverse events can be counterbalanced if the association is more effective and reduces disease symptoms.”

FDA Could Approve Avastin Soon

The FDA’s most recent approval for treating mesothelioma was Tumor Treating Fields, a therapy involving electric currents that disrupt cell division and inhibit tumor growth.

The recent multicenter study in France included 425 patients who completed the health-related quality of life assessment. It was orchestrated by the French Cooperative Thoracic Intergroup.

The primary objective of the study was to determine if adding Avastin to standard chemotherapy improved median survival, which it did from 16.1 months to 18.8 months.

More than 80% of study participants had the epithelioid cell type of mesothelioma, which is the most treatable.

“It is important for a mesothelioma patient to be reassured that the addition of a third molecule [Avastin] to the standard-of-care chemotherapy combination will not alter [their] quality of life,” Westeel concluded.

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