Several studies of Avastin incombinations are ongoing but none employing irinotecan and Avastin. Bevacizumab was associated with significant toxicity, including venous thromboembolic events, in the first-line treatment of metastatic urothelial carcinoma in the phase II Hoosier Oncology Group GU04-75 trial presented at ASCO 2009. Among 43 patients receiving cisplatin, gemcitabine (Gemzar), and bevacizumab (Avastin), 60% required at least one dose modification and 42% discontinued therapy because of toxicity, including 21% who stopped bevacizumab due to deep vein thrombosis (DVT) or pulmonary embolism. However, there was an improvemetn in survival although strangely not in progressoin free survival.
Sawhney , D Bourgeois , and UB Chaudhary
Neo-adjuvant chemotherapy for muscle-invasive bladder cancer: a look ahead
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Positive response to bevacizumab in a patient with metastatic, chemotherapy-refractory urothelial carcinoma, Anti-Cancer Drugs:
April 2008 – Volume 19 – Issue 4 – pp 427-429
N. M. Hahn, W. M. Stadler, R. T. Zon, D. M. Waterhouse, J. Picus, S. R. Nattam, C. S. Johnson, S. M. Perkins, M. J. Waddell, C. J. Sweeney; Indiana University Simon Cancer Center, Indianapolis, IN; University of Chicago, Chicago, IL; Northern Indiana Cancer Research Consortium, South Bend, IN; Oncology and Hematology Care, Inc., Cincinnati, OH; Washington University, St. Louis, MO; Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN; Indiana University School of Medicine, Indianapolis, IN; University of Adelaide, Adelaide, Australia, A multicenter phase II study of cisplatin (C), gemcitabine (G), and bevacizumab (B) as first-line chemotherapy for metastatic urothelial carcinoma (UC): Hoosier Oncology Group GU-0475. J Clin Oncol 27:15s, 2009 (suppl; abstr 5018)