The Expert Breast Cancer Panel of the National Comprehensive Cancer Network (NCCN), which convened July 10-12 in Philadelphia, Pennsylvania, voted to maintain the current recommendation and position on Avastin (bevacizumab) in its treatment of metastatic breast cancer.
The NCCN’s Clinical Practice Guidelines in Oncology for Breast Cancer define the recommendation as follows: “Bevacizumab in combination with paclitaxel is an appropriate therapeutic option for metastatic breast cancer with the evidence designation 2A.” The “2A” designation means that there is agreement among NCCN committee members about recommended treatment, but there is not a great deal of prospective, randomized trial data currently available to back up the committee’s decisions. However, lower-level evidence does suggest that the recommendation is appropriate.
Interestingly, the FDA does not share the NCCN’s opinion of Avastin, as it has recommended withdrawing the drug’s breast cancer indication after a panel hearing in June. Use of the drug was not in dispute for colorectal cancer, glioblastoma, renal cell carcinoma, and lung cancer. However, the FDA Commissioner, Margaret A. Hamburg, MD, will make a decision on whether Avastin should be approved for the treatment of breast cancer after the post-hearing comment period ends on July 28.
In the meantime, physicians are still able to prescribe Avastin to their patients, but insurance companies may not reimburse for it without breast cancer data being noted in the drug’s prescribing information. Medicare will still continue to pay for Avastin, despite its considerable cost (about $88,000 per year) and the FDA’s recommendation to withdraw its use in patients with metastatic breast cancer.
NCCN Breast Cancer Panel reaffirms current position and recommendation regarding the use of bevacizumab in metastatic breast cancer [press release]. Fort Washington, PA. National Comprehensive Cancer Network; July 19, 2011. Available at: Business Wire
. Accessed July 21, 2011.