Avastin Doubles Progression-free Survival In Advanced Kidney Cancer

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Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 05 Jun 2007 - 14:00 PDT


Adding the angiogenesis inhibitor bevacizumab (Avastin) to standard treatment for advance renal cell cancer doubles progression-free survival, according to a major European study reported at the American Society of Clinical Oncology annual meeting (1-5 June, 2007; Chicago, USA).

. The AVOREN study randomised 649 patients with metastatic renal cell carcinoma to treatment with interferon alpha-2a (9MIU sc three times a week), a standard of care for advanced kidney cancer, plus bevacizumab (10mg/kg iv every two weeks) or placebo. Adding bevacizumab increased progression-free survival by 47%, from 5.4 months to 10.2 months (hazard ratio 0.63; p<0.0001). The tumour response rate was 31.4% for patients treated with bevacizumab compared to 12.8% in those given interferon alpha-2a alone.

The combination was generally well tolerated, with fatigue being more frequent with bevacizumab (12% vs 8% with placebo), loss of muscle strength (10% vs 7%) and proteinuria (7% vs 0%).

"These results are important because there is a real need for more effective treatments in advanced kidney cancer, where chemotherapy and radiotherapy are not as effective as in other cancers," said Professor Bernard Escudier, Head of Immunotherapy, Institut Gustave-Roussy, Paris, France, and lead investigator of the study. "Avastin is an important new treatment option."

The five-year survival is currently less than 5% in patients diagnosed with advanced renal cell carcinoma. Addition of bevacizumab to interferon treatment showed a trend to improved overall survival (HR 0.75; p<0.0267) although longer follow up is needed to complete the results.

Bevacizumab targets vascular endothelial growth factor (VEGF), a key mediator of angiogenesis, so it inhibits the development of new blood vessels essential for tumour growth and metastasis. VEGF is overexpressed in around 90% of cases of renal cell carcinoma, explained Professor Escudier. "This means that targeting VEGF is a particularly rational approach in this type of cancer and should be effective, even in monotherapy." Based on the AVOREN study, Roche has submitted a Marketing Authorisation Application to the European Medicines Evaluation Agency.

Written by:
Susan Mayor PhD, freelance medical journalist, London, UK
mayor@dircon.co.uk


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