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Avastin and Me-One Breast Cancer Survivor’s Thoughts

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Avastin (bevacizumab) was heralded with great expectations that it was part of a new era of hope for breast cancer treatment.  It was even rushed to approval for the treatment of advanced breast cancer before completing the studies usually required to show that it did indeed extend lives.  There is now a controversy about whether or not the drug actually does extend lives for end-stage breast cancer or not.

Avastin has had some success with other cancers and is widely used and highly profitable.  It was also found to be of use in helping to prevent blindness in those with the wet form of macular degeneration.  Although Avastin is a very expensive drug, the monthly cost of an Avastin treatment for macular degeneration is quite reasonable because only a very small dose is necessary.  This is of great interest to me because I was recently diagnosed with an early form of macular degeneration called dry macular degeneration.

When my eye doctor mentioned Avastin I recognized it as the drug used by some of my friends in the breast cancer world.  So, I checked it out and was surprised to find that there was a huge controversy about Avastin and another newer macular degeneration drug called Lucentis.  Both drugs come under the arm of the Swiss pharmaceutical company Roche, but are products of Genentech, a company from the United States.

The National Eye Institute is conducting a study comparing the effectiveness of Avastin to Lucentis.  Apparently Genentech originally declined to sell Avastin to the National Eye Institute.  Avastin treatments for macular degeneration cost about $50 a month and Lucentis, the newer drug, costs about $1,500 a month.  In one article Roche contended that they had spent a lot of money creating the newer drug and deserved to make a profit on it.  It appears to me that they attempted to find a way to demonize Avastin for use in macular degeneration, saying that when it was sold to compounding pharmacies who made it into usable tiny doses for macular degeneration, they could somehow contaminate it and make it unsafe for use.  They found four clinics in Canada that had had a few instances of eye inflammation to back up their claims.  They then refused to continue to sell it to compounding pharmacies, but, after massive protests by eye doctors who had safely administered countless effective doses, they agreed to sell it only to the eye doctors themselves, who must then send it to the compounding pharmacy of their choice to be made into usable small doses.

As I understand it, and it is confusing, the National Eye Institute study is currently being conducted so they must have gotten the Avastin in some way.  I am guessing their doctors were able to buy it directly.  The first results of the studies will be available sometime in the first half of 2011.

I want to trust drug companies to create drugs to advance our health.  I do not believe that there are great numbers of individuals involved with drug companies who set out with the intention of creating some drugs that cause more harm than good or of creating drugs that are simply more profitable than their predecessors while providing limited, if not non-existant, advantages over less expensive older drugs.  I don’t want to believe this.  Yet, I must wonder how this seemingly does happen in spite of many dedicated individuals involved in the pharmaceutical industry.

I believe Avastin versus Lucentis controversy illustrates that there is a strong possibility that Roche, at least in the case of macular degeneration, may be more interested in the profit motive than in saving eyesight.  If they are willing to go so far as to try to prevent eye doctors from having access to a drug that works to prevent blindness in order to force them to use a vastly more expensive drug that may, or may not, work better, how can we trust them about other drugs?  I really want to trust them.

Mary Miller- Breast Cancer Profile in Courage

Leucentis vs. Avastin:  A Macular Degeneration Treatment Controversy
Article describing the situation.

http://www.allaboutvision.com/conditions/lucentis-vs-avastin.htm

Head-to-head trials could threaten Roche Lucentis franchise in AMD
This article details the potential financial threat to Roche if Avastin is found comparable to Lucentis.

http://www.thepharmaletter.com/file/95426/head-to-head-trials-could-threaten-roche-lucentis-franchise-in-amd.html

A blog article that does a good job of summarizing the situation with Avastin, concentrating on the situation with breast cancer but mentioning the controversy with macular degeneration.

http://scienceblogs.com/insolence/2010/09/the_saga_of_avastin_and_breast_cancer.php?utm_source=networkbanner&utm_medium=link

Articles regarding Avastin and its possible removal as a treatment for breast cancer:

http://breastcancer.peoplebeatingcancer.org/article/fda-panel-urges-limits-avastin

Not everyone agrees about this.  Some women believe that Avastin has significantly extended their lives.  They fear for their lives if the FDA removes approval for breast cancer.  

http://peoplebeatingcancer.org/article/fda-says-breast-cancer-drug-did-not-extend-lives

An article that is decidedly against using Avastin for breast cancer and an excellent retort from a man whose wife has been successfully treated with it for over two years.

http://www.knowbreastcancer.org/news-research/news/nbcc-response-to-odac-vote-on.html

I’ve Seen What Wonders This Drug Can Do (an article praising Avastin)
An article about Avastin for bowel cancer and some insight about the problems of using it in the United Kingdom.

http://www.dailymail.co.uk/health/article-1305861/Cancer-drug-Avastin-work-wonders.html

An interesting time-line of the history of Genetech is provided by the company: 

http://www.gene.com/gene/about/corporate/history/timeline.html

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