A single drug can have many uses. This is certainly the case for Avastin (bevacizumab), which is widely used to treat a number of different kinds of cancer. The drug may protect against the spread of yet another.
A new phase 2 trial demonstrates that combining Avastin with standard chemotherapy and radiation is not only safe, but could extend the lives of people living with advanced nasopharyngeal (nose and throat) cancer.
The drug may be effective in preventing the spread of this disease, the most common cause of oral cancer deaths.
Nancy Y. Lee, M.D., a radiation oncologist from Memorial Sloan-Kettering Cancer Center in New York and colleagues from the Radiation Therapy Oncology Group (RTOG) conducted the phase 2 trial which explored adding Avastin to chemoradiation, the standard treatment for nasopharyneal cancer.
While intensity-modulated radiotherapy (IMRT) can control tumor growth in some 90 percent of patients, nose and throat cancer has the highest rate of metastasis (spreading beyond the original tumor) of all head and neck cancers.
Around 30 percent of patients have cancer in other areas within 4-5 years after their original diagnosis.
Avastin improves treatment and prolongs life for patients with a number of different advanced cancers, including colorectal, kidney and lung cancers.
It works by blocking what’s known as the vascular endothelial growth factor (VEGF-A), something seen in nearly two-thirds of nasopharyngeal cancers and an indicator of poor outlook.
This research involved 46 patients with advanced nasopharyneal carcinoma from 19 centers in North America and Hong Kong. These patients had not yet undergone any treatment. Avastin was added to the standard regimens of chemotherapy.
Combining the therapies saw significant improvements. More than 90 percent of patients survived for two years without distant metastasis, and the disease did not get worse in 75 percent of patients.
Adding Avastin did not seriously increase treatment toxicity and didn’t interfere with patient compliance, as compared to standard chemoradiotherapy.
Study authors say additional research is needed to identify patients at greatest risk of distant metastasis who could benefit from the combination therapy.
Trial results were published December 15, 2011 Online First in The Lancet Oncology.
The Oral Cancer Foundation estimates that 37,000 people in the United States will be diagnosed with oral cancer each year, and 8,000 people will die from it. Nine out of every ten oral cancers are squamous cell carcinomas which spread quickly and most commonly originate on the tongue, but can also appear on the gums, inner cheeks, lips, and roof and floor of the mouth.
Tobacco use is associated with 75% of all oral cancers, and it includes smokeless tobacco, cigars and pipes as well as cigarette smoking. Heavy alcohol use alone is also a prominent risk factor, and when tobacco use and alcohol use are combined together, it produces a synergistic effect that greatly increases the risk for oral cancer. New research has shown that human papillomavirus-16 (HPV-16), the same virus responsible for most cases of cervical cancer, is also causing many cases of oral cancer in both tobacco users and non-tobacco users alike. People who have suppressed immune systems, such as people who have had organ transplants and are on anti-rejection drugs, are also prone to developing oral cancer.