Torisel and Avastin for renal cell carcinoma – pro

Combination of Avastin and Temsirollimus for solid tumors is in a trial in renal cell carcinoma, NCT00619268. The TORAVA trial is designed to evaluate the progression-free rate at 48 weeks of a combination of Torisel® and Avastin® given at first-line treatment in patients with metastatic renal cancer. In addition, Wyeth Pharmaceuticals, in May, 2008 announced the initiation of the INTORACT (INvestigation of TORISEL and Avastin Combination Therapy) study, a worldwide randomized, open-label, phase 3b study comparing TORISEL® (temsirolimus) plus Avastin® (bevacizumab) versus Avastin plus interferon-alfa for first-line treatment of patients with advanced renal cell carcinoma (RCC). Wyeth Research is conducting the INTORACT study with the support and assistance of Roche and Genentech.

Both Torisel and Avastin are effective for renal cell carcinoma. Torisel is FDA approved as a single agent. Avastin is also an effective treatment for renal cell carcinoma.

Several studies indicate that Avastin is effective for renal cell carcinoma. A randomized, double-blind, Phase II trial was conducted comparing placebo with bevacizumab at doses of 3 and 10 mg per kilogram of body weight, given every two weeks in 166 patients with renal cancer, with significant positive results for Avastin. According to updated results from a phase II clinical trial presented at the 23rd annual Chemotherapy Foundation Symposium, treatment with the combination of Tarceva® (erlotinib) and Avastin® (bevacizumab) resulted in good survival among patients with metastatic renal cell carcinoma. Current NCCN guidelines recommend Avastin as an option for crossover therapy of renal cell carcinoma after first line therapy with IL2, sorafenib or sunitinib.

The combination of the two drugs, however, is not proven becauseit does not have scientific evidence the permits conclusions ot its effect on health outcomes and the above noted trials are ongoing.

Coppin C, Porzsolt F, Awa A, et al. Immunotherapy for advanced renal cell cancer. Cochrane Database Systematic Rev. 2004;3:CD001425.

Hainsworth J, Spigel D, Greco A. Combination Therapy with Bevacizumab and Erlotinib for Patients with Metastatic Clear Cell Renal Carcinoma. Proceedings from the 23rd annual Chemotherapy Foundation Symposium. New York. 2005; Abstract #22.

Aimery de Gramonta, Eric Van Cutsemb, Investigating the Potential of Bevacizumab in Other Indications: Metastatic Renal Cell, Non-Small Cell Lung, Pancreatic and Breast Cancer, Oncology Suppl. 3, 2005

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