Avastin for gallbladder and cholangiocarcinoma – pro

There is not much experience with the use of Avastin in cholangiocarcinoma or gallbladder cancer and medical necessity has not been established.  A Taiwanese report used it in a single patient in 2006. Holen and colleagues also investigated this combination in previously untreated advanced gallbladder cancer or cholangiocarcinoma. The data were presented at the 2008 ASCO annual meeting. Twenty-nine patients were eligible for enrollment; 3 out of 17 (17.6%) evaluable patients achieved partial response (PR). The projected accrual is not completed yet for this trial, and final efficacy data are therefore pending.  Several other trials are ongoing to investigate the efficacy of bevacizumab with cytotoxic agents, and/or radiation in biliary duct and gallbladder cancer:  One such study is: Gemcitabine, Oxaliplatin in Combination With Bevacizumab in Biliary Tract and Gallbladder Cancer, NCT00361231
The purposes of this study are to test the safety of bevacizumab when given in combination with gemcitabine and oxaliplatin and to see what effects (good and bad) this combination has on patients with cancer of bile duct or gallbladder.

Tai CJ, Chiou HY, Wu CH, Pan S, Liu JD. Rapid resolution of liver metastasis from cholangiocarcinoma after bevacizumab with cisplatin and high-dose fluorouracil plus leucovorin. Onkologie. 2006;29:179–180.

Holen KD, Mahoney MR, LoConte NK, et al. Efficacy report of a multicenter phase II trial testing a biologic-only combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer (BC): A Phase II Consortium (P2C) study. J Clin Oncol. 2008;26(Meeting Abstracts) Abstract 4522.

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