A survey conducted by Dubai Hospital of the United Arab Emirates indicates that many community oncologists will continue using the antiangiogenic cancer drug bevacizumab (Avastin) to treat their breast cancer patients despite the FDA’s controversial decision to revoke the drug’s labeling for this indication. Among 564 physicians who took the survey, more than four out of 10 said they would continue to use the drug under certain circumstances for their patients (the survey was conducted before the FDA made its final decision to revoke the breast cancer label for Avastin). Of the oncologists surveyed, 15% were from the United States, 31% were from Europe, and the remainder from other countries.
The FDA initially granted accelerated approval to Avastin in 2008 for the first-line treatment of HER-2 negative metastatic breast cancer. Avastin is an angiogenesis inhibitor, a drug that blocks tumor blood vessels. After further studies showed that Avastin slowed disease progression by only about two months, and can be associated with serious side effects, the FDA began a process to revoke the breast cancer label for the drug. Despite the FDA decision, oncologists can continue to use the drug on an off-label basis, and the survey indicates that many will continue to do so. It is less clear how many insurance companies will continue to pay for Avastin, but the Federal Medicare and Medicaid programs have indicated they will continue to cover the drug for metastatic breast cancer.