Bowel cancer therapy in the UK could be on the verge of a new era after
European regulators yesterday gave the go-ahead for the use of Roche's cancer drug Avastin in a much wider setting.

The broader label allows for the use of Avastin (bevacizumab) in combination with any standard chemotherapy at any stage of a patient’s treatment for advanced bowel cancer which, the company claims, could “revolutionise bowel cancer treatment in the UK and benefit thousands of people diagnosed with [the disease] each year”.

Having already demonstrated a survival benefit of nearly five months in combination with an irinotecan-based chemotherapy, the new label will allow the use of Avastin alongside standard fluoropyrimidine-based chemotherapies such as capecitabine or oxaliplatin, substantially expanding its user base.

Following its European approval for use alongside intravenous irinotecan-based chemotherapies in 2005, the National Institute for Health and Clinical Excellence rejected the drug’s use on the National Health Service early last year, on grounds that the regimen was not cost-effective.

However, given that Avastin’s use has now been approved in combination with oral chemotherapies, which will free up NHS resources by removing the need for IV administration, Roche is hopeful that such a regimen will now meet the cost-effectiveness benchmark, and thereby become a permanent addition to the treatment menu for the disease, a spokesperson explained to PharmaTimes UK News.

NICE reassessment mid-year?
In the meantime, doctors will be able to prescribe Avastin for its wider indication until NICE reassesses the drug which, the company hopes, could be as soon as the middle of the year, the spokesperson said, but stressed that this was pure speculation.

Colorectal cancer is the second most common cause of death from cancer in the UK, and is usually treated by chemotherapy and biologic therapies. But if therapy with Avastin, capecitabine and oxaliplatin is indeed considered a cost-effective use of NHS resources, then “more patients may be able to benefit from this treatment leading to improved survival, while maintaining good quality of life,” according to Dr Tim Iveson, Consultant Oncologist, Southampton General Hospital.

Avastin, which works by choking off the blood supply to tumours thereby preventing their growth, has previously been hailed ‘a pipeline in a product’ because of its potential in treating several different tumour types, and is also approved in Europe for breast, lung, and kidney cancer.