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 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.