by Barbara C. Good, PhD

When government approval for the drug Avastin^TM  (bevacizumab) was revoked for the treatment of advanced breast cancer last November, there were protests from women who had received it and were convinced the drug helped lessen their disease or even kept them alive.  Now two studies, one from the National Surgical Adjuvant Breast and Bowel Project (NSABP) in Pittsburgh and the other from the University of Frankfurt, Germany, have demonstrated that this drug may have a role to play in the treatment of early-stage breast cancer.

Avastin in these studies was used before surgery in women whose disease had not spread.  In both studies, the women who received it had lower rates of cancer once surgery was performed.  The side effects of this drug can be serious, and additional studies are continuing to see if these results hold up.  Tissue samples from these studies are also being examined to determine if women whose tumors contain particular genetic characteristics may respond more successfully to the drug.

For additional information about these studies, click here.

Abstracts of the studies as they appeared in the New England Journal of Medicine can be found here and here.

Oncotype DX is a laboratory test developed by Genomic Health, Inc., that has been used to predict the likelihood of chemotherapy benefit and recurrence risk in ER-positive, HER2-negative early stage invasive breast cancer. A report from the San Antonio Breast Cancer Symposium held in December indicates that the test can also predict the likelihood of local recurrence for patients with ductal carcinoma in situ (DCIS).

This study indicated that the test is able to identify women with DCIS who are at low risk for recurrent disease, ie, patients who may be able to avoid radiation therapy after surgery, and those at higher risk, who may require radiation therapy. This means that those who require more treatment would be the ones to receive it, while those with a less aggressive form of DCIS would be able to avoid the side effects sometimes associated with radiation therapy.

DCIS has historically represented a challenge for physicians, who have used a wide spectrum of treatment options from breast conserving surgery with or without radiation to mastectomy. Lumpectomy has become the current standard, following a trend in breast cancer surgery to not “overtreat” patients who may have a less aggressive form of the disease.

More information on this study can be found here.