Continuing Avastin Beyond Initial Cancer Progression Improves Survival Time

Continuing Avastin® (bevacizumab) beyond the time when advanced colorectal cancer gets worse helps patients, according to new study reports.  Patients who continued to receive Avastin with a new chemotherapy regimen after their cancer first progressed lived almost 12 months longer than patients who got more chemo but stopped Avastin.  Both groups did better than those who had no further treatment at all.

BRiTE (Bevacizumab Regimens: Investigation of Treatment Effects and Safety) observed progress of three groups of patients when their cancer got worse after their first chemotherapy treatments.  All patients had Avastin as part of the first chemo, some continued it beyond that first cancer progression.

Groups included those who got:

  • No further treatment with either chemotherapy or Avastin
  • Chemotherapy but no further Avastin
  • A change in chemotherapy and continued Avastin

Doctors chose which treatment regimen to follow when cancer first progressed.  Despite that, there were not large differences in the three groups with respect to age, sex, race, or the time that had elapsed before the first cancer progression.

BRiTE patients were treated by their own oncologists in almost 250 different places in the United States.

Researchers analyzed both overall survival time (from the time chemotherapy first began until the patient died) and survival beyond first progression (from the time doctors determined that cancer had progressed until patient death).  All calculations are medians — the midpoint of the entire group.

Overall median survival time for the three groups was:

  • No further treatment after progression:  12.6 months
  • Chemotherapy, no Avastin:  19.9 months
  • Chemotherapy with continued Avastin: 31.8 months

Median survival time after first progression

  • No further treatment: 3.6 months
  • Chemotherapy only: 9.5 months
  • Chemotherapy plus Avastin: 19.2 months

Safety: There were no meaningful difference in the most serious Avastin-related side effects among the three groups including problems caused by blood clots in the arteries, severe bleeding, or gastrointestinal perforations.  More patients who continued Avastin did have new or worse hypertension, which was treated.

Axel Grothey, M.D. and the BRiTE study team concluded,

These results from a large, prospective, observational study suggest that continued vascular endothelial growth factor inhibition with bevacizumab beyond initial progressive disease could play an important role improving the overall success of therapy for patients who have metastatic colorectal cancer.

SOURCE: Grothey et al., Journal of Clinical Oncology, Early Release, October 14, 2008.

Genentech, the manufacturer of Avastin, provided support for BRiTE.

Disclosure: C3 has accepted funding for projects and educational programs from Genentech in the form of unrestricted educational grants. C3 has ultimate authority over website content.


  1. Maggie Lane says

    Am I correct in reading the study that continuing Avastin AFTER one finished the initial treatment is beneficial? I received 12 rounds of Oxaliplatin/Avastin/Flourouracil (Stage IV colon cancer)and then treatments stopped. That was 7 months ago. Just last week I had to demand to have a new CT scan to see where I’m at!

  2. Kate Murphy says

    Your doctor can give you a better idea of when you can resume chemotherapy. It depends on what treatment you needed for the perforation.

    Some perforations resolve themselves without surgery. Others need surgical treatment.

    You need to be recovered from the effects of the perforation and beyond risks of infection before getting back to treatment.

    Talk to your doctor about a plan.

  3. Mary says

    I had Avastin added into my chemo after my first recurrence. When we finished the 12 treatments of FOLFIRI with Avastin, we continued the Avastin every 3 weeks. Then, we went back to FOLFIRI with Avastin and when that finished we have continued Avastin every 3 weeks. I firmly believe it’s the difference between me still being here, fighting, and me not.

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