Treatment Options

Can anyone tell me the difference between Avastin plus carboplatin vs Avastin plus CPT-11?  Is one more effective?  Are side effects different?

I've just completed my 5th month of bi-monthly Avastin/CPT-11 treatments, hoping to go on indefinitely. No tumor regrowth since surgery in Septemer 07. The only side effect I've had from CPT-11 (ironotecan) is diarrhea. It was pretty severe a few weeks ago, but I seem to have outlasted it and it's been lessening the past couple of treatments. From what I've read about carboplatin its most worrisome possible side effect is myelosuppression where platelets a white cell counts are lowered. There are many  in neuroncology who believe changing chemo combos every once in a while may have the ability to 'fool' those little tentacles into not reforming into a tumor. There are others who believe you should stick with a winner. If it's working and the tumor is stable, why change? Probably doesn't help much but I understand your angst.

I have a relative needs to go on one soon.  One Dr. recommended Avastin and CPT-11, but another Dr. says no, Avastin plus Carboplatin is better.  From what I have read, it looks to me like the side effects of the carboplatin are more severe than the CPT-11 so I am wondering why the Carboplatin instead of the CPT-11.

Our dad was just diagnosed with a GBM.  We are currently at MD Anderson seeking their advise.  It is my understanding that we will be doing the "standard of care" with 6 weeks of radiation and temador.  The temador will be followed up afterwards.  Are there questions we should be asking regarding this first treatment options?  Any words of wisdom would be greatly appreciated.

Kim 

 

My husband had Avastin and carboplatin for a couple of months.  Also he had CPT-11 and Thalidomide for 6 months earlier in 2007, but it failed.  Actually both failed I'd have to say.  He had been receiving CPT-11 free on a clinical trial.

At the time we started Avastin/carboplatin, our NO said she her Avastin patients were about 50-50 on either CPT-11 or carboplatin.  The big successful study with the good results was done with CPT-11, so that is what she would prefer to use, but since it cost $6000 a dose, if insurance did not cover it she would use carboplatin which was easier to get approved.  She said her patients did well on each, neither seemed better than the other for results. 

Side effects--well he did not have the infamous CPT-11 diarrhea, instead he had bad constipation.  On Avastin/carboplatin, he had no side effects apart from a couple of days of fatigue.  On neither one did he have any blood crashes.