Bruce Roth, MD, Medical Oncologist, Professor of Medicine, Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, discusses the treatment of several cancers with bevacizumab.

Bevacizumab is not an adequate treatment for all types of cancer. At the time of surgery, if a tumor appears to be vascular, it does not necessarily mean that the patient will benefit from bevacizumab.

This idea is further complicated in the case of central nervous system (CNS) tumors, Roth says. There are patients who respond to bevacizumab as second-line therapy, so it was originally assumed that the agent would be beneficial if incorporated in a first-line regimen. This hypothesis has been tested, and unfortunately, no evidence of benefit has been seen. Bevacizumab did not demonstrate benefit in a trial looking at patients with CNS tumors.

Roth says that one change in the characteristics of a tumor could make it less highly vascular and more infiltrative and aggressive later on. In this situation, one must expect less benefit from a vascular disruptive agent like bevacizumab.

Roth says that bevacizumab is the perfect example of a highly effective drug in one disease that does not translate to any other type of malignancy or that may work in one stage of a disease and not another.

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Bruce Roth, MD, from the Siteman Cancer Center, Washington University School of Medicine, discusses the treatment of several cancers with bevacizumab.

Dr. Roth on the Treatment of Cancers With Bevacizumab

Bruce Roth, MD, Medical Oncologist, Professor of Medicine, Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, discusses the optimism for a cure with immunotherapies.

Patients and members of the media will often ask when a new treatment will translate into a cure, Roth says, though this is not a reasonable expectation for advanced solid tumors in the near future.

If these disease types could be converted to a chronic state with newer therapies without progression or symptoms, this would be a huge step forward. If these treatments were then taken to an earlier stage of the disease, one could expect to improve survival or increase cure rate.

There is always a bit too much excitement about some data reported at the ASCO Annual Meeting, Roth says, but researchers and physicians try to put things in perspective and avoid overselling. Roth asserts that the idea that a cure is the only victory is incorrect.

Bruce Roth, MD, from the Siteman Cancer Center, Washington University School of Medicine, discusses the optimism for a cure with immunotherapies.

Bruce Roth, MD

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