Avastin

Hi all,

My dad has nsclc stage 4, and has recently used the new drug avastin...does anyone know if this drug crosses the blood brain barrier??? He was just recently diagnosed with brain mets???
Radiation doc suggests whole brain radiation, but I'm not sure what to expect from this memory loss?? brain damage????

pls help

Luckystar:
How did your Dad get a prescription for Avastin? I posted a message on the Non-Small Cell message board on 7/12/05 asking if anyone was taking Avastin and how they were able to get the prescription. I am currently taking Tarceva and would like to take Avastin as well - I've heard the combination really shrinks lung tumors. My doctor said that Avastin had not been approved for lung cancer yet (just colon cancer) and I would have to pay the full price for Avastin @ $33,000 per month!

As far as the blood-brain barrier, I asked my doctor at MD Anderson about the effectiveness of Tarceva on the brain - she said that there is a lot of controversy on this subject (i.e., whether chemo or medications cross the blood-brain barrier). She told me that some doctors opine that the cancer weakens the blood-brain barrier, hence letting the cancer in, and that medication such as Tarceva and Avastin may enter the brain through those weakened spots. Others doctors believe that the blood-brain barrier will not permit chemo agents into the brain. Bottom line, she told me, is that the doctors really don't know for sure.

I had one brain met in the left upper lobe - about the size of a pea. I had the stereotactic surgery (also know as X-knife procedure) - it's not really "surgery" in the sense that they do not cut you open - they put a metal "halo" on your head with four screws that helps keep you head from moving during the procedure and then they radiate the lesion. I think this procedure can be performed on several mets at one time (possibly up to a maximum of 3 mets, but don't quote me on this!). The procedure is considered a success if the brain lesion stops growing - my lesion actually shrunk considerably - from the size of a pea down to the size of a grain of rice. The doctor will continue to monitor my brain every 3 months with a MRI for any new activity (hopefully none!). I do remember my doctor telling me that whole brain radiation will cause short-term memory loss and, since I am still working, I decided to wait until further mets (if any) show up. I hope this information helps....
Take care!
- Kim

To Kim:
Thank you Kim for your ideas on the new medicine Avastin. As for my dad, he was diagnosed w/NSCLC stage 4 in June 05' and we started chemo begining of July. Initially, our doc did not suggest using Avastin, but about 2 weeks before chemo she said that she wanted us to use Avastin in combination w/Taxol and carboplasin for this type of lung cancer. So she wrote to our insurance company and gave them all the info. with the use of these drugs in combination and they approved us for the drug. You are right about the drug being approved for colon cancer, but don't quote me on this though, but I think I saw something on the internet that they did case studies on pts. w/NSCLC using Avastin in combination w/Taxol and carboplasin, and was finished sometime in April or May of this year. The Avastin helps shrink down the tumor, but the only downfall is that this drug may cause serious hemorraging, but everyone's going to be different!!!!! My dad's tumor starting in the lung,and was about 3inches in size, but after using this new drug the tumor started to break down/necrosis in the center of the tumor!!! We just finished our third cycle of chemo, and his labs results are finally looking better. His CEA tumor marker dropped dramatically.... but now the only thing that we are faced w/is the brain mets using whole brain radiation. I'm glad to hear that the radiation that was done for you made the tumor shrink.....My family will pray for you...stay strong and have faith!!! As for my dad I wish it were that simple to do radiation like your procedure.My dad has multiple tumors in both rt and lt hemispheres of the brain and in other areas too. take care luckystar

I do not know about Avastin but there is some research linking 5FU (Flourisil) to brain dementia issues.   My mom had no cognitive issues before her treatment regimen and has now developed rapid vascular dementia, having no contributing or risk factors for this kind of dementia.  I am convinced (and a nuero radiologist said there is a possibility) that the chemo caused it.  I am currently angry about this as her oncologist always dismissed our concerns about her cognitive decline.   I am trying now to learn if there is anything that can be done to stabilize or reverse any of the effects now that she is off chemo.

 

Brigid