High risk of developing ONJ for cancer patients on bisphosphonates

Source: Dr.Bicuspid.com Research has shown that cancer patients on bisphosphonates are at risk of developing osteonecrosis of the jaw (ONJ) and that those on the intravenous form of the drug are at a higher risk compared with those on the oral drugs. However, a new study that looked at cancer patients on zoledronic acid (ZOL) and chemotherapy combined with the antiangiogenic agent bevacizumab (BEV) who underwent a dental exam before starting treatment found that none of them developed ONJ (JADA, May 2011, Vol. 142:5, pp. 506-513). Researchers from the University of Siena in Italy investigated the incidence of and risk factors for ONJ in patients with metastases to the bone from solid tumors who received ZOL and BEV. Their study included 59 patients (34 with breast cancer and 25 with non-small cell lung cancer [NSCL]) who received 4 mg of ZOL intravenously every four weeks and 15 mg per kg of BEV every three weeks. The median time the participants received ZOL therapy was 18 months, while the median time participants received BEV therapy was 16 months. The researchers took several measures to reduce the study participants' risk of developing ONJ, including the following: Dental caries and periodontal disease were treated before starting study treatment. Mouth rinses with chlorhexidine and local antibiotic agents were administered before baseline oral hygiene. Recommendations were made for maintaining good oral hygiene. Teeth were extracted at least four weeks before starting ZOL and BEV therapy. Invasive dental procedures were avoided during treatment. If invasive dental [...]

Fatal adverse events with Bevacizumab

Source: Medscape Today Treatment-Related Mortality With Bevacizumab in Cancer Patients: A Meta-analysis Study Summary Although bevacizumab has been shown to improve survival in patients with a variety of solid tumors when added to conventional chemotherapy, it has also been associated with life-threatening and fatal adverse events (FAEs), including bleeding, thromboembolism, and perforation. This improvement in survival has led to the assumption that FAEs are rare and do not significantly affect patients who are receiving treatment. In this large meta-analysis, Ranpura and colleagues identified 10,217 patients with various solid tumors from 16 randomized studies, as follows: Colorectal cancer (5 studies); Non-small cell lung cancer (4 studies); Breast cancer (3 studies); Renal cell cancer (2 studies); Pancreatic cancer (1 study); and Prostate cancer (1 study). A clear increase in FAEs was evident in patients who received bevacizumab compared with those who received standard chemotherapy alone (2.5% vs 1.7%; relative risk [RR] 1.46; P = .01). This association varied with chemotherapy agents but not with tumor type. In particular, FAEs occurred in patients receiving taxanes or platinum agents (RR 3.49; 3.3% vs 1%) but not with other specific agents. Types of FAEs included bleeding (23.5%), gastrointestinal perforation (7.1%), and pulmonary embolism and stroke (5.1% each). Most fatal bleeding events were pulmonary or gastrointestinal in origin. Viewpoint The benefit of bevacizumab is under increased scrutiny given the latest data in patients with metastatic breast cancer. In this large meta-analysis, Ranpura and colleagues documented a clear increase in the rate of FAEs (2.5%) in patients [...]

ASCO: Non-platinum regimen works in head, neck cancer

Source: www.medpagetoday.com Author: Michael Smith, North American Correspondent, MedPage Today A novel non-platinum-based regimen was efficacious in recurrent or metastatic squamous cell head and neck cancer, researchers said. The combination of pemetrexed (Alimta) and bevacizumab (Avastin) yielded a response rate of 30% in a small single-arm trial, according to Athanassios Argiris, MD, of the University of Pittsburgh, and colleagues. The combination also increased the length of time before patients progressed, and increased median overall survival, Argiris and colleagues reported in a poster discussion session at the annual meeting of the American Society of Clinical Oncology here. Patients with recurrent or metastatic disease typically have a poor prognosis, the researchers said, with median survival between six and nine months with standard chemotherapy. But, in other research, adding the monoclonal antibody cetuximab (Erbitux) to platinum-based chemotherapy increased survival, they said. Bevacizumab is a monoclonal antibody that targets the vascular epithelial growth factor (VEGF), which is expressed in squamous cell head and neck cancer; high levels of VEGF correlate with poor outcome, they noted. The researchers hypothesized that the antibody might enhance the activity of pemetrexed, which is a multi-targeted antifolate indicated for malignant pleural mesothelioma and non-small cell lung cancer. To test the idea, they analyzed results of treating 37 patients given 500 mg/m2 of pemetrexed and 15 mg/kg of bevacizumab intravenously every 21 days until disease progression. Patients were also given folic acid and vitamin B12. The primary endpoint of the study was time to progression, they said, but the researchers [...]

Monoclonal Antibody Drugs for Cancer Treatment

Source: www.newswise.com Author: staff The strategy of using monoclonal antibodies for cancer treatment was first described in the late 1970s with the promise that they could be developed into therapies that were highly specific to cancer cells, killing them with few or no side effects. For several types of cancer, monoclonal antibodies have already offered this advantage to patients. For other cancer types, they have provided an additional therapeutic weapon, but with smaller benefits and sometimes new side effects. "The first efforts for monoclonal antibody cancer therapy were to find antibodies that would home in on tumors and bind to proteins on the surface of cancer cells," explained physician-scientist David A. Scheinberg. "We looked for unique proteins that were specific only to cancer cells. The idea was that the antibody would be used to stimulate an immune response in the body, which would kill the cancer cell." Dr. Scheinberg, who is Chair of Memorial Sloan-Kettering's Experimental Therapeutics Center and the Molecular Pharmacology and Chemistry Program within the Sloan-Kettering Institute, developed an antibody called M195, which targets a protein on leukemia cells, when working as a research fellow in collaboration with Memorial Sloan-Kettering immunologist Lloyd Old in the 1980s. This approach further evolved when researchers realized they could use the antibody as a carrier to deliver a radioactive isotope or a toxic drug directly to the cancer cell, where it would kill the cell while sparing nearby healthy tissue. Antibodies are proteins that help the immune system to identify foreign substances [...]

Tarceva® and Avastin® safe and effective for patients with squamous-cell head and neck carcinoma

Source: professional.cancerconsultants.com Author: staff Researchers from the National Cancer Institute and the University of Chicago have reported that the combination of Tarceva® (erlotinib) and Avastin® (bevacizumab) is well tolerated and produces sustained responses in some patients with recurrent or metastatic squamous-cell head and neck carcinoma. The details of this study appeared in the March 2009 issue of Lancet Oncology.[1] Tarceva is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. EGFRs are small proteins that are found on the surface of all cells. EGFR binds exclusively to small growth factor proteins circulating in the blood. The binding action between EGFR and growth factors stimulates biological processes within the cell to promote growth of a cell in a strictly controlled manner. However, in many cancer cells, EGFR is either abundantly over-expressed or the EGFR biological processes that normally stimulate cell growth are constantly active, leading to the uncontrolled and excessive growth of the cancer cell. Tarceva is approved by the U.S. Food and Drug Administration (FDA) for the treatment of non–small cell lung cancer and has significant activity in a variety of tumors, including hepatocellular carcinoma, pancreatic cancer, colorectal cancer, and renal cell cancer. Avastin is a humanized monoclonal antibody that is targeted against the vascular endothelial growth factor (VEGF). Avastin is approved by the FDA for the initial treatment of advanced colorectal cancer in combination with 5-fluorouracil-based therapy and has demonstrated an improvement in survival when combined with Camptosar® (irinotecan)-based chemotherapy in the treatment of this disease. Avastin was also [...]

Bevacizumab better than gold standard imaging at detecting tumors

Source: www.biocompare.com Author: staff Scientists have developed a new imaging agent that can be used in scanning for tumours, and which gives a much clearer and more precise image than existing methods. The discovery has the potential to revolutionise pre-clinical cancer research and clinical diagnostic practice, and it makes use of compounds that have already been approved for treating patients: the anti-cancer drug bevacizumab (Avastin) and Copper-64, a radioactive copper nuclide, which is approved by the US Food and Drug Administration (FDA) for some clinical trials. Dr Zheng Jim Wang told the 20th EORTC-NCI-AACR [1] Symposium on Molecular Targets and Cancer Therapeutics in Geneva today (Wednesday 22 October) that he and his colleagues had attached bevacizumab to a molecule called DOTA (a cyclic compound) and tagged it with a radioactive tracer, Copper-64 (64Cu). Bevacizumab is an antibody that targets vascular endothelial growth factor (VEGF), a signalling protein released by tumour cells and which plays an important role in angiogenesis (the process by which a growing tumour creates its own blood supply). Currently, bevacizumab is being used to treat patients with advanced colorectal cancer and is being tested in several other metastatic cancers. When the researchers injected the compound (64Cu-bevacizumab) into mice with breast, lung and pancreatic cancers and then used PET/CT imaging to scan the animals, they found that it successfully targeted the cancer cells, accumulating in high concentrations in the tumours, and that it enabled clear and well-defined images of the tumours to be detected during scanning. When compared [...]

Go to Top