Bevacizumab, the world’s best-selling cancer drug, is now being tested in mesothelioma patients and having overall good results in extending life spans. Commonly referred to by its brand name, Avastin, the Genentech-manufactured drug was approved by the Food and Drug Administration (FDA) for use in some cancers such as colorectal cancer and lung cancer.
In early clinical trials, bevacizumab helped some mesothelioma patients live longer with less severe symptoms. However, the drug’s rare but serious side effects have some researchers questioning its safety. When the drug was combined with certain other drugs, researchers saw a spike in deaths caused by treatment complications. For now, the drug is still in the testing phases for use against mesothelioma.
Doctors may inject the drug or give it through an intravenous drip, a process that can take a few hours. Patients generally need the drug once every three days.
Bevacizumab is sometimes classified as a chemotherapy drug, but it does not fight cancer in the usual way. Whereas typical chemotherapy attacks rapidly dividing cancer cells, this drug ensures that tumors don't receive necessities like oxygen and nutrients. It does this by inhibiting angiogenesis, which is the growth of blood vessels within the tumor. If angiogenesis occurs, mesothelioma cells have a support system within the body and can divide and spread more easily. But without angiogenesis, cancer cells are starved of vital nutrients and slowly die. When bevacizumab prevents angiogenesis, it stops mesothelioma from spreading and kills cancer cells that are already present.
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In some cancers, including mesothelioma, it is commonly used in combination with other chemotherapy drugs such as gemcitabine. This way, bevacizumab works to stop angiogenesis while other drugs focus on attacking the tumor itself. However, research shows that some combinations with bevacizumab can lead to deadly side effects.
Bevacizumab commonly causes minor side effects such as dizziness, dry mouth, fatigue, heartburn and loss of appetite. In rare cases, it may cause severe side effects such as blood clots in the lungs, hemorrhaging, holes in the stomach and low white blood cell count. These potentially deadly complications are most common when it is used in conjunction with a chemotherapy drug.
A study of clinical trial results revealed that patients treated with bevacizumab and chemotherapy are 1.5 times more likely to die because of treatment complications than patients treated with chemotherapy alone. Some argue that the death rate is still low at 2.5 percent and that the potential benefits of the drug are worth it. When used against deadly cancers like mesothelioma, the elevated death rate may be a small risk for a drug that may extend life span in most patients.
A 2008 study tested the effects of bevacizumab with chemotherapy in 24 mesothelioma patients who previously underwent other treatments with no positive results. The combination was successful in slowing disease progression in half of patients. Overall, patients lived a median of 5.8 months after being treated with the drug. Researchers reported that it was well-tolerated and warranted further study.
In a case study the following year, a mesothelioma patient underwent treatment with bevacizumab and gemcitabine after other treatments had failed to shrink his tumor or control his symptoms. The combination helped prevent fluid buildup and pain, leading to a better quality of life. This finding suggests that bevacizumab may aid in palliative, symptom-reducing care in addition to potentially curative, life-extending treatment.
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