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OCEANS' undercurrents

ASCO: Price, side-effects lead doctors to differ over Avastin in ovarian cancer

Avastin bevacizumab may offer a new weapon against recurrent ovarian cancer, but oncologists rendered split verdicts on whether Phase III data at the American Society of Clinical Oncology meeting were compelling enough to make it standard of care, especially given its price.

The tepid reception was in stark contrast to the enthusiastic reaction to data for new melanoma drugs at the ASCO meeting in Chicago last week.

The state of treatment in the two diseases is not dissimilar. New agents have not shown significant gains in progression-free survival or overall survival in either setting in many years.

But in melanoma, doctors are ready to adopt Yervoy ipilimumab from Bristol-Myers Squibb Co. and vemurafenib from Roche and Daiichi Sankyo Co. Ltd. as the new standards of care based on improvements in OS of less than three months compared with chemotherapy - never mind that Yervoy has been associated with fatal autoimmune reactions and is priced at $120,000 for a full regimen (see Cover Story).

By comparison, the Phase III results showing Avastin produced a 50% improvement in PFS and an interim analysis showing a nonsignificant five-month improvement in OS in recurrent ovarian cancer were greeted with reservations.

For some doctors, the PFS benefit is not big enough to replace combination chemotherapy - which does not work very well - as the standard of care.

Those doctors say the reason is Avastin's price tag and the risk of side effects.

New data

In February, Roche's Genentech Inc. unit announced Avastin met the primary

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