Tuesday 5 July 2016

Temozolomide+Radiation+Avastin in Newly Diagnosed?

My dad was diagnosed with stage four GBM in early June. His MGMT is methylated. Due to the size, etc. of the tumor, his NOs recommend adding Avastin to his standard care of temozolomide and radiation. The more I read the more confused I get about whether this is a good idea. Any thoughts? We are also working on adding Optune to his treatment regiment.

Also, has anyone had experience with the Stanley Brothers' CBD products?

Thanks,
Stephanie


5 comments:

  1. One problem with Avastin is that it would immediately make him ineligible for several of the best clinical trials for recurrent GBM, most notably this one, which is one of the best out there:

    https://www.clinicaltrials.gov/ct2/show/NCT02529072

    as well as several others.

    However, if the tumor is inoperable or too large, he would not likely be eligible for those trials anyway.

    In general, upfront Avastin does not improve overall survival versus delayed Avastin (two phase three trials showed this), although in certain circumstances it could be beneficial upfront, for example in patients who'd be unlikely to tolerate further therapy at recurrence (the elderly or patients with a low KPS), or for patients on high doses of dexamethasone to control edema (Avastin can also help with this). It's hard to say without knowing all the details of his situation.

    Optune would definitely be a good idea if he is willing to go for it.

    I'll follow up with a few more question by email.

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    1. I am happy to provide more info. via email or here, if that helps. I have his full pathology report now, though parts of it are still foreign to me. Thanks again.

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  2. I totally agree with Stephen. Our NO keeps recommending Avastin. I keep telling him we will save that as a last resort. My husband will hit his 3 yr marker next month since newly diagnosed. He wore the Novocure arrays for 1-1/2 yrs. We are a big fan of Novocure/Optune.
    Best,
    Candy

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    1. Thanks for the feedback, Candy. I appreciate it.

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