Dr. West, I just read this article re: maintenance Avastin and have a few questions.
The last line reads: "At this point, I’m continuing with avastin and not continuing the avastin after patients have progressed and are moving on to second-line therapy."
So does this mean you'd continue Avastin as a maintenance drug after first line? Or would you recommend a break for the patient showing stable or NED? Would Avastin be continued for someone who had brain surgery the year before? I've tried to find new info on Avastin and can't find much of anything. Will it be a common maintenance drug if it was used in first line with chemo? Thanks as always.
Take care, Judy
Reply # - September 16, 2012, 12:37 PM
That was written more than five years ago. These days, I'm more inclined to follow the plan of continuing patients on Alimta (pemetrexed) and Avastin (bevacizumab), after starting them on carboplatin with both Alimta and Avastin. The AVAPERL study demonstrated that the Alimta/Avastin combination in maintenance was superior to Avastin alone, and the results looked that way as well on the just reported PointBreak trial.
There is a lot of variability in how it's used or not used in maintenance, but the way I do things is among the most common approaches.
Avastin appears to be safe to give to patients who have had a prior surgery, including brain surgery, if they don't have new or symptomatic brain metastases.