Avastin® (bevacizumab) is a Prescription Medicine used to treat metastatic (spreading) colorectal and kidney cancer.Avastin should not be used if you have untreated cancer in your brain or spinal cord. Tell your doctor if you have inflammation of the bowel or stomach ulcers; high blood pressure; a history of bleeding and/or blood clots, stroke or a blocked lung artery; a history of Reversible Posterior Leukoencephalopathy Syndrome (RPLS); have had major surgery in the last 28 days or a wound that has not healed properly; are pregnant or breast feeding; have heart disease, have ever received anthracylines for cancer or radiotherapy to your chest; or are >65 years of age. Possible unwanted effects: Common: high blood pressure, body pain, tiredness/weakness, diarrhoea, nausea, constipation, bleeding, sore mouth, mouth ulcers, loss of appetite, shortness of breath, nose bleed, runny nose, dry, scaling or inflamed skin, change in skin colour, taste change, dizziness/faintness, headache, sleepiness/drowsiness, wounds that won’t heal, changes in your voice, fever. Serious (rare): severe body or stomach pain; severe diarrhoea, nausea and vomiting; pain and/or swelling in the lower legs, feet or hands; severe bleeding; seizures, headache, abnormal thinking, and/or eye problems; abscesses, severe infections; feelings of numbness or tingling in feet or hands. Ask your oncologist if Avastin is right for you. Use strictly as directed. If symptoms continue or if you experience side effects or would like further information, please talk to your oncologist or pharmacist, or visit www.medsafe.govt.nz for Avastin Consumer Medicines Information. Avastin (100mg in 4mL and 400mg in 16 mL vials) is an unfunded medicine, you will need to pay for this medicine. A prescription charge and normal oncologist fees may apply.
Glioblastoma multiforme (GBM)
The most common form of brain cancer is known as a primary brain tumour. A primary brain tumour is a tumour which starts in the brain, rather than a tumour which has spread from another part of the body (commonly called metastases). Primary brain tumours are the 10th most common cause of cancer death in NZ.
The majority of primary brain tumours are called high-grade astrocytomas, of which the majority are glioblastoma multiforme (GBM). There are approximately 100-120 patients diagnosed with GBM in NZ each year.
GBM is technically known as a high-grade astrocytic tumour, which is a type of glioma. Gliomas are tumours that involve the cells that support and protect the nerve cells in the brain and spinal cord. Astrocytic tumours are also the most common types of brain tumour, and develop from a type of star-shaped cell called an astrocyte. They can occur in most parts of the brain and occasionally the spinal cord.
GBM tumours grow fast and are likely to spread to other parts of the brain. It is common for these tumours to come back after initial treatment, in what is known as recurrence or disease progression.
Treatment for brain cancer
Treatment options for primary brain tumours depend on a number of factors: your general health, the size, grade (how abnormal the tumour looks under a microscope) and position (where it is in the brain or spinal cord) of the tumour. Tests will enable your doctor to decide on the best type of treatment for you, this can be any one of or a combination of surgery, radiotherapy and medications.
Your treatment will usually be planned by a team of specialists, known as a multidisciplinary team (MDT). The team will usually include a doctor who operates on the brain (Neurosurgeon), a doctor who specialises in treating illnesses of the brain (Neurologist), a specialist in treating cancer (an Oncologist), a specialist nurse and possibly other health professionals such as a physiotherapist and dietician.
Chemotherapy and biologic therapy
The medications used to treat GBMs include chemotherapy, and biologic therapy like Avastin. Avastin is a treatment that works by cutting off the blood supply to the tumour and has been proven to improve survival times in other cancers such as colorectal cancer, or delay progression in cancers such as lung cancer and breast cancer. Avastin is considered a new treatment for GBM and clinical trials have shown that when given for recurrent GBM, (GBM that has returned after initial treatment) Avastin has shown good results and is well tolerated. It should be noted that Avastin is approved for use only for relapsed high grade malignant gliomas. Read more about Avastin at the site for consumer medicines information.