Avastin

[kazrazmataz]

Can anyone tell me if they have been prescribed Avastin with firstline treatment or is it a drug they only prescribe after? Its just that my husband is asking the criteria for getting Avastin and I don't know the answer. I am in the Midlands England. Thanks.

[TrishLey]

Hi There

I was on Avastin for 2nd line treatment and maintenance afterwards. I think its normally 2nd line but I wouldn't be 100% sure.

Wishing you all the best

xxx

Trish

[baxbird]

I was prescribed Avastin towards the end of my first line treatment and have it now for maintance. (I'm in Hampshire )

Dawnxx

[kazrazmataz in reply to baxbird]

I'm going go ask for it next appointment see what they say as I don't think they routinely offer it and I suspect its got more to do with the funding so if they say no I will drill down and do a bit of campaigning myself re the postcode lottery scenario.

[Whippit in reply to kazrazmataz]

Karen, I don't think it's a postcode issue in England. There are criteria that apply equally to everyone regardless of the postcode. However, I've noticed there are additional criteria for 2014 which seem to me to restrict the number of centres that will have the means to administer it. Specifically, 'therapy to be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy.' It might be a more helpful question to your consultant, having established it might do you good, to ask if they have staff who have received the correct training to give you Avastin.

If not, at least in England you will not drag round your postcode like a prisoner does his fetters. You can ask to be referred for treatment to another centre that does have the expertise to administer Avastin.

xxx Annie

[hmmartin]

I was prescribed avastin from cycle 4 of my first line chemo carbo/taxel. It is available through The Cancer Drug Fund.

Unfortunately my cancer progressed within 3 months of completing 6 cycles of carbo/taxel even though avastin continued.

Best wishes Maureen

[Whippit]

Hi Karen

Lucky you living in England. Lucky me living in Wales but accessing my NHS care in England! You can see the list of drugs that are available from the National Cancer Drugs Fund in England at the following address:

england.nhs.uk/wp-content/u...

Avastin is listed under it's medical name 'Bevacizumab'. It's available for both first and second line but you can only have at either first or second line in England, and there are very specific criteria which you would have to meet in order to receive the drug. One of the criteria is that is only offered to women who have residual disease after surgery. Your oncologist will also be able to let you know if there are any medical reasons why it might not be appropriate. It's not suitable for everyone who meets the NCDF criteria. Best to discuss this with your oncologist, ask what possible side-effects it might have, and weight up the pros and cons of taking the drug at first line.

I hope this is helpful. Patients in England are very lucky that everything is made so clear. You can probably also look up Bevacizumab on the NHS Choices or the Roche websites to find out more.

Good luck with your decision-making. xxx Annie

[kazrazmataz in reply to Whippit]

Thanks Annie, hope you are having a nice relaxing day after yesterday, its lovely how the ladies on this site are right behind you, like Team Annie I say Lolx

[Whippit in reply to kazrazmataz]

Hi Karen, did you find the information on Bevacizumab? I realise it would have been more helpful to everyone had I cut and pasted from the National Cancer Drugs Fund List 2014. Here's the entry for Bevacizumab (Avastin) for ovarian cancers.

BEVACIZUMAB (Avastin)

The first line treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer where all the following criteria are met:

1. Application made by and fist cycle of systemic anti-cancer therapy to be prescribed by a consultant specialist specifically trained and accredited in the use f systemic anti-cancer therapy.

2 Chemotherapy naïve advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (not licensed at this dosage).

3 1st line indication

4. Either FIGO stage III debulked but residual disease more than 1 cm, or FIGO Stage IV

5. Given with Carboplatin and Paclitaxel combination chemotherapy

6. Bevacizumab to start with:

* 1st or 2nd cycle of chemotherapy following debulking surgery or an attempt at debulking surgery (either performed pre-chemotherapy or after 3 cycles of neo-adjuvant chemotherapy, OR

* 1st or 2nd cycles of chemotherapy for those patients will stage IV disease OR inoperable disease

7. Bevacizumab dose to be 7.5 mg/kg every 3 weeks

8. Maximum of 18 cycles of Bevacizumab

9. As this dosage of Bevacizumab is not licensed in ovarian cancer it must be used within the treating Trust's governance framework.

Note: This policy is NOT for patients with stage I-III disease who have had optimal debulking.

BEVACIZUMAB

The second line treatment of advanced epithelial ovarian, fallopian tube or primary peritoneal cancer where all the following criteria are met:

1. Application made by and first cycle of systemic anti-cancer therapy to be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy

2. 2nd line indication

3. Platinum sensitive epithelial ovarian, fallopian tube or primary peritoneal cancer (6 or more months after completion of first line chemotherapy)

4. Given with Carboplatin and Gemcitabine combination chemotherapy

5. PS 0 or 1

6. No previous treatment with bevacizumab or other anti-VEGF treatment

7. Bevacizumab dose to be 15mg/kg every 3 weeks Note: Bevacizumab should be discontinued due to toxicity or disease progression, which ever occurs first.

Hope this is helpful. I noticed additional criteria have been set for Bevacizumab in 2014 and it gives me the impression that not all centres may have the means to prescribe and administer it.

xx Annie

[kazrazmataz in reply to Whippit]

Thanks Annie, I did read it the hyperlink worked no probs but at least everyone can see it now. Interesting that it may depend on specialist training. Looks like funding is not the only issue with the postcode lottery! I have been diagnosed with stage 1V so looks like on paper I qualify but it was not offered me from the outset so maybe the staff at my hospital are not trained or they use other criteria not listed just hope its not down to cost saving. However I am not on Paclitaxol as had an allergic reaction at chemo 2 which they substitute with Caelyx so that on paper rules me out, we'll see.

[Whippit in reply to kazrazmataz]

Dear Karen, I think it's worth asking your hospital about Avastin. As I say it doesn't suit everyone and could do some patients some harm. It's a balance between getting the best life expectancy figures for the UK, and what's best for the patient and sometimes you have to push in the nicest sort of way.

xx love Annie

[rjhs]

Hello Karen, I had it prescribed for the final three sessions of my first line chemo, immediately following surgery and for 15 further sessions at three week intervals. Apparently it is only funded for a year and only once here. I am in the East Midlands.

Rita

[TornacLiz]

Strewth it's complicated isn't it!

I was given Avastin for a first line treatment. I had chemo plus Avastin for 3 x cycles then surgery then more chemo and Avastin and now on Avastin only. I was told this would be my only opportunity to have Avastin. I think just discuss it with your oncologist! Good luck.

[passenger1]

I agree with TorasLiz

If you are offered it I would take it, as my understanding that this is only offered for 1st and 2nd line treatment

After this we do not have the option for Avastin.

Good luck Regards Barbara.

[MaggyH]

I had avastin with taxol/carbo as my 1st line treatment and then continued on it as a maintenance treatment for a further 8 months.

Love Brenda x