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Tuesday, June 05, 2007

Treating Blood Vessels as the Enemy
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Cancer and macular degeneration have more in common than you may suspect.

The connection is blood supply. In order for malignant tumors to grow they need to create new blood vessels to provide oxygen and nutrients to the enlarging mass. If circulation is interrupted the tumor cells will eventually suffocate and die.

The wet form of age-related macular degeneration involves abnormal blood vessels proliferating underneath the retina where they do not belong. These new blood vessels are substandard, they leak and cause bleeding, fluid accumulation and eventual scarring (subretinal fibrosis). This explains why folks with wet form ARMD see so poorly.

In both situations, cancer and ARMD, therapies which inhibit blood vessels can hopefully stop the disease in its tracks - or at least slow it down so that other treatments can work.

Avastin (Bevacizumab) is an injectable genetically-engineered treatment that stops abnormal blood vessels from growing. Originally it was offered as a primary form of cancer chemotherapy. Vision researchers tinkered with its formula so it could be injected into eyes with wet form ARMD and marketed it as the drug Lucentis. FDA approval for Lucentis is approaching its first anniversary.

Lucentis is very expensive and regular repeat injections are required. Some eye specialists offered the cheaper Avastin to ARMD patients as an alternative treatment. The final word has not been written whether or not Avastin is comparable to Lucentis for ARMD. For now it is recognized as "off-label" use.

Well, Avastin is back in the news again regarding its usefulness in fighting cancer. It seems that adding Avastin to an established cancer chemotherapy regimen significantly boosts the survivorship of patients with metastatic colorectal cancer. These findings were recently presented at the Annual Meeting of the American Society of Clinical Oncology in Chicago. Previous researchers made similar Avastin claims in patients with advanced breast cancer.

So, what does this news mean? Whenever new treatments are introduced it is only the beginning chapter. Many medical discoveries find alternate uses that may surpass its original intended design. When fighting disease, just like when you're healthy, always be ready for surprises!

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Posted by: Dr. Lloyd at 12:34 PM

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