Avastin first line of ovarian cancer is now generally accepted as a component of combination chemotherapy and is reviewed separately. The issue is. Should one continues Avastin into the next line of therapy after progression. For chemotherapy, if a drug failed in first line, it should not be continued in the second line (exceptions are when a long time had elapsed since the initial remission and the like). Unfortunately there is no literature specifically in ovarian cancer to support continuing Avastin after progression. Patients with ovarian cancer that has recurred or progressed following prior therapies, have unfavorable long-term outcomes with standard therapies. Although additional chemotherapy can be used to treat these patients, they often have minimal anti-cancer responses as well as side effects from treatment. NCCN has now added Avastin to its list of recommended drugs for ovarian cancer. NCCN supports second line use of Avastin alone or in combination, when it had not been used – on p. OV-D, 1.
I found that 2011 ASCO educational book favors continuing Avastin into consecutive line of therapy but the only evidence that it adduced is from the BRITE study, which was for colon cancer and not ovarian cancer.
Read the Professional version here.