TUESDAY, April 17 (HealthDay News) -- Medicare patients who have
advanced non-small cell lung cancer appear to get no survival
benefit from adding the drug Avastin to standard chemotherapy,
researchers from the Dana-Farber Cancer Institute report.
An earlier trial had found that Avastin (bevacizumab) did
improve survival, but not in patients aged 65 and older. Even so,
the researchers noted, most patients diagnosed with non-small cell
lung cancer are 65 and older and Medicare still covers the cost of
"A drug that we were just ecstatic about in 2006, we have to be more circumspect about," said lead researcher Dr. Deborah Schrag, an oncologist at Dana Farber, in Boston.
Avastin should be used judiciously, she added, noting that
"older patients should discuss it with their doctors, but we cannot
say it provides a survival advantage based on these data."
However, Schrag does not think Medicare needs to reconsider
funding Avastin. "It may be that it helps some patients," she said.
"But we should not assume that Avastin needs to be part of the
Genentech, the maker of Avastin, said in a statement Tuesday
that while the study "is well-conducted, retrospective analyses
that use administrative information to determine clinical outcomes
"Genentech agrees that certain people, such as those older than 65, are typically underrepresented in randomized, controlled clinical trials used for regulatory submissions. To address this, we collect and present data on the 'real world' use of medicines through large phase 4 prospective observational studies, which even when well-designed, also have limitations, including non-randomization of study participants."
The cost of the medication is also a factor in considering the
use of Avastin, experts have said.
In 2011, published reports pegged the cost of the drug at
somewhere between $4,000 and $9,000 a month, depending on co-pay
assistance that's available from Genentech, Avastin's
This latest report was published in the April 18 issue of the
Journal of the American Medical Association. The U.S. National Cancer Institute funded the study.
For the study, Schrag's team randomly assigned more than 4,000
Medicare patients with advanced non-small cell lung cancer to one
of two groups.
One group received Avastin plus chemotherapy, while the other
group was treated with chemotherapy alone. The researchers compared
survival between the groups.
They found average survival for patients receiving Avastin plus
chemotherapy was 9.7 months, compared with as much as 8.9 months
for patients on chemotherapy alone.
In terms of one-year survival, it was 39.6 percent for those
getting Avastin and chemotherapy and 40.1 percent for chemotherapy
When they took into account demographic and clinical
characteristics in adjusted models, the researchers did not find a
significant difference in overall survival between patients treated
with Avastin and chemotherapy and those treated only with
Dr. Norman Edelman, chief medical officer of the American Lung
Association, said, "As I pointed out in the past, it is important
to study ways to extend quality of life in advanced lung
This study shows that a drug that was useful in a general age
group is not effective in an older age group, he added. "Thus, it
may save older patients exposure to an ineffective drug with side
effects," he said.
"It is critical that, to the extent possible, we study treatments separately in groups known to differ in responses, rather than subject all to average responses," he said.
For more information on lung cancer, visit the
U.S. National Cancer Institute.
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