Added to FOLFOX chemotherapy, Avastin® (bevacizumab) reduced active colorectal cancer that had spread to the liver and also protected the liver from chemo damage before surgery.

A research team at MD Anderson Cancer Center in Texas studied liver tumors from colorectal cancer patients removed during surgery and also changes in non-cancerous liver tissue.  They compared liver pathology from patients who received oxaliplatin and 5FU (FOLFOX) alone to those who were treated with Avastin along with FOLFOX.

Tumor viability was defined as the percentage of remaining active cancer compared to overall tumor area.

When Avastin was added to FOLFOX chemotherapy,

  • There was significantly less tumor viability — 32.9 percent compared to 45.3 percent.
  • More patients had less than 25 percent remaining viable tumor cells  — 45 percent versus 23 percent.
  • However, there was no difference in the percentage of patients whose tumors responded completely, resulting in no cancer cells present.  About 11 percent of patients in both groups had a complete pathologic response to treatment before surgery.

In addition, Avastin protected the liver from chemotherapy damage.  Changes in small blood vessels in the liver known as hepatic sinusoidal dilation occurred less often and was less severe:

  • Any grade:  27.4 percent versus 53.5 percent in those who did not receive Avastin.
  • Moderate or severe:  8.1 percent compared to 27.9 percent.

Speaking for the research team, Dario Riberio MD wrote,

In patients treated with 5FU/OX chemotherapy, bevacizumab improves the pathologic response, as demonstrated by a reduction of the degree of tumor viability, and reduces the incidence and severity of hepatic injury. This retrospective study provides additional evidence supporting the use of bevacizumab in combination with 5FU/OX for colorectal liver metastases.

SOURCE:  Riberio et al, Cancer, Volume 110, Issue 12, December 2007.

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