Dr. Rugo on the Efficacy of Bevacizumab in Breast Cancer

Hope S. Rugo, MD, clinical professor, Department of Medicine (Hematology/Oncology), and director, Breast Oncology Clinical Trials Program, University of California, San Francisco, discusses the efficacy of bevacizumab (Avastin) at treating breast cancer.

Gauge the efficacy of bevacizumab is difficult because there are still many unknowns. The best dosing schedule and the patient populations that are most effected is still unclear. Although the ability to reverse resistance and improved progression-free survival has been demonstrated the cessation of the drug can increase malignant angiogenesis. The pros and cons still remain unclear.

Rugo postulates that a more thorough understanding of the subgroups could help predict a greater benefit to the drug. In addition to the populations a closer look needs to be concentrated on whether the drug is best given in combination with chemotherapy alone or with other targeted therapies. It is clear from studies in glioblastoma that when you stop the drug you get enhanced angiogenesis. This is another concern that needs to be addressed.

The future of research and funding for bevacizumab remains unclear; this stresses the importance of being careful and cautious when seeking accelerated approvals.