Gene Expression Signature May Predict Avastin Benefit
The Clearity Foundation
Deb Zajchowski, PhD
The search for a biomarker to predict response to the angiogenesis inhibitor, bevacizumab (aka Avastin), may be nearing a successful conclusion. Researchers at Edinburgh Cancer Research Center in Scotland reported that they may have discovered such a predictor for ovarian cancer patients treated with Avastin. They presented their findings at the June ASCO meeting and showed that this predictor is not a single gene or protein, but a “signature” that combines information from 63 genes. The information is derived from molecules in the cell called messenger RNAs (mRNA), which act as communicators between the DNA blueprint in the cell nucleus and the cellular protein-making factory by giving instructions for the type of proteins that are to be made. The investigators used tumor samples collected during a previous Avastin clinical trial (ICON7) in newly diagnosed patients who had surgery followed by standard platinum-based chemotherapy with or without Avastin. They measured mRNA for these 63 genes in the tumors and designated them as “pro-angiogenic” or “immune”-like. Those patients with “immune-like” tumors lived longer than those with “pro-angiogenic” tumors, suggesting that this signature might also be a prognostic marker. Importantly, those women with “immune-like” tumors did not benefit when they were given Avastin as first-line treatment and for maintenance. These results must be confirmed in additional studies and still need to be evaluated for recurrent ovarian cancer patients who receive Avastin-usually in combination with other chemotherapies. But, the current data suggest that there may soon be a molecular test that will help patients and their doctors make informed decisions regarding the use of Avastin based on their tumor molecular profile in addition to the clinical factors, including cardiovascular issues or intestinal involvement of the cancer.
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