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Genentech: Britain's National Health Won't Pay for Avastin

The National Institute for Clinical Excellence (NICE) is correct about Genentech’s (DNA) Avastin.

The media and too many financial analysts are either hype Avastin or do not know what they are talking about. The real Avastin clinical benefits are very marginal if any.

Let us examine the facts of using Avastin in various cancers:

1. Metastatic colorectal cancer (mCRC)
Avastin benefits in 1st-line mCRC are very marginal when the drug is used in combination with the latest chemotherapy like Folfox or Folfiri. The latest clinical trials did not show any Overall Survival (OS) benefits.

The information that Avastin increases OS by 5 months comes from the old trial when Avastin was combined with an old chemotherapy drug (irinotecan).

Yes indeed, Avastin increased OS from 15 months to just over 20 months. However, the new chemo drug Folfox alone provides the same 20 months OS.

Many physicians are using Avastin in 3rd-line mCRC but there are absolutely no clinical data to support such Avastin use in this setting at all. This is called "off-label" use.

2. Lung Cancer
Avastin did show 2 months OS benefits for a very select group of lung cancer patients (OS was increased from 10 months to 12 months).

3. Breast Cancer
Avastin did not show any OS in breast cancer patients.


Lately, the FDA approves cancer drugs based on Progression Free Survival (PFS). PFS is a cancer marker showing that cancer progression was halted/delayed. However, PFS is a very complicated marker when radiologists must very carefully examine patients x-rays determining tumor sizes. This is a very subjective process since tumors' boundaries are not very clear.

Very often the company and independent radiologists come to different conclusions regarding to PFS. At the same tome, OS is a very precised parameter (a patient is either alive or dead).