Moving on to Avastin. Questions!

Devastating, but not unexpected news for my husband's MRI yesterday. MRI with spec and perfusion, results today are that there is progression at the original tumor site in the margin of the tumor bed (right temporal lobe) AND the new lesion they spotted on his cerebellum is a new GBM. 

I'm told that Avastin will probably be the next step. I already knew that would most likely be what they would decide to do.

How long, in general, does the the actual infusion take?  Is the normal protocol one infusion every two weeks? Please share your experiences with Avastin. 

thanks,

OMH

My husband has been diagnosed with stage 4 lung cancer and liver cancer.  This happened in July of this year.  He has been on Avastin once a month since then.  The treatment takes about an hour total.  Hope this helps

So sorry about the news.  But Avastin is a great drug - at least, it has been for my dad.  The first infusion took the longest, because they do the "drip" so slowly, in order to make sure there are no immediate, dangerous side effects.  It was over an hour from the time they started.  After that first successful infusion, the second (2 weeks later) was a little quicker - 45 minutes.  The next, also 2 weeks later, was approximately 30 minutes.  That seems to be about where they stay.  I did learn at our last visit that 2 infusions are considered one "cycle", just an interesting tidbit.  So, after 4 infusions, we are about to start "cycle 3, part 1", on 11/17.

The part that takes the longest, at least in our infusion suite, is that they cannot order the Avastin from the hospital pharmacy until his labs come back & the NO oks the treatment for the day.  And it's kind of a major ordeal when they bring it in to the suite - serious drug protocols observed! It's worth a tidy sum, so I do understand not wanting to have to toss it down the drain if something doesn't work out! But, just be aware that there is alot of set up time before the actual "drip" starts.

The good news is, side effects seem to be minimal, and hopefully this will be true for your husband as well.  A couple of hours after the first infusion we were sitting in a courtyard restaurant in Charleston eating seafood and having a lovely time when the NO called to check up!  His voice is raspy, which we think may be related, although could be radiation as well, I suppose.  He is convinced chocolate milkshakes make it better, and I have to admit, he's right.  I would prefer him to drink smoothies, but we compromise - quality of life, right? :)

All best wishes to both of you -

Bev

daughter of Craig, 61 yo GBM, dx 8/5/09

Hi OMH,

Avastin worked really well for us.  Infusions are slow at first, then get progressively faster.  We went every two weeks with few (if any) side effects.  Others' experiences may differ, but that was ours.  Feel free to check our Caring Bridge site for more 411.  Take care, janni

http://www.caringbridge.org/visit/stevecalloway

Andy has had two Avastin IV's. 30 min each, no side effects except SOMETHING is helping his tumors to shrink because his headaches have been lessened. :o)

I agree about the long set-up. Be prepared. And next time we're bringing the laptop, DVD, headphones, etc. It can be over two hours for both the avastin and the carboplatin. zzz!

sarah

I had Avastin with CPT-11 for almost 15 months. Yes, the setup is frustrating: it is with all infusions. Blood work has to be done and read; onc has to order the drugs, pre-meds have to be administered (zofran, decadron, sometimes other antiemetics)--that takes about 20 minutes to drip. Avastin, as you've been told, is about a 30 minute drip. CpT-11 was 90 minutes (ugh). I always brought a few snacks and something I like to drink and something to do. TVs there--yes--but daytime TV gets old pretty quickly. I had clear scans on Avastin for over a year. And minor side effects, which were attributed to the CPT-11. Hope it works as well for you

My husband had Avastin for about 22 months. He recently had reccurance,so it has been discontinued.

Avastin was very tolerable. He did the bi weekly infusions along with the 5/23 Temador.

I agree with what the others posted. It is a time consuming way to get treatment ,but considering the alternative......

My husband only had problems with being cold for the first two months or so and then after that he cruised right along.

Good luck with your treatment!

Hi there.  My husband has been on Avastin since last June '09 when his post radiation MRI showed that his tumor  that as 99% removed grew back and crossed over the midline to the left frontal lobe.

He gets infusions every other week and is also one Temodar 5/23.  His first infusion was the longest as others have mentioned at about 2 hours.  His subsequent infusions are an hour (most I hear are 30 minutes).  We are typically there for 2 hours from start to finish.  They need to check his blood, blood pressure and also chat to see how he's doing.  He's started out with IV fluids and for about 10 minutes or so and then the Avastin is started and the IV fluids are stopped.

He has had minimal side effects -- his voice gets raspy as one other person noted in the posting.  He's also more tired the day of and after his treatment.  Occasionally he'll have some stomach issues but nothing unbearable.

As for the efficacy -- his first MRI after 3 Avastin treatments showed a 40% decrease in the tumor size and the next MRI showed another decrease of 10% so it's working so far.

Avastin can inhibit healing so surgery is out of the question after it's started, it can also increase blood pressure so they'll continually monitor that.  Additionally it can cause protein in urine -- affects kidneys so once a month they'll do a urine analysis. 

Some folks opt for a port to infuse the Avastin but we decided against it as his veins are pretty good and given the aggressiveness of his tumor, we wanted to start him ASAP and didn't want to wait for the outpatient procedure.

Hope this helps.  Write if you have any other questions.

My mother who is 59 was diagnosed in Jan 08 with GBM. She did the standard form of treatment when reoccurance in Nov 08.  She is on Avastin now and has been since the beginning of May 09.  So six months and all is well.  Two week infusions with the 30 minute drip but by the time your outta there its about 2 1/2 hours later.  Just as everyone else has stated they have to check her protein in her urine before they start and then comes the order for the 26,000 dollar drug.  She has little side effects except for fatigue the following few days and it seems to make her scalp itch and break her out with pimples.  It also raised her blood pressuer so she is on blood pressure meds no to keep it under control.  Avastin is showing a decrease in the tumor size and according to her NO its doing its job.  Were keeping our fingers crossed that it contiues to work.  Good luck,

Hi,

My Father who was diagnosed with GBM in January, 2009 is now takling Avastin with his Temodar 7 days on and then off(total of 14 days/month). He has had two Avastin infusions and it is one infusion every two weeks. It takes about 30 minutes for the infusion, but prior to it they have to do bloodwork to check blood counts, so you have to wait until the results are back and the pharmacy has to get the order. We always plan on a couple of hours at the hospital. My dad had a slight progression a month ago and so this why we are taking this route. I do believe it is working as his symptoms are improving..hunger/appetite is back for the first time in 9 months and no headaches. Hope this helps.

Tricia (daughter of Terry)