Avastin Plus Chemotherapy Improves Progression-Free and Overall Survival in Mucosal Melanoma

Avastin (bevacizumab) with carboplatin plus paclitaxel improved overall survival (OS) and progression-free survival (PFS) compared with carboplatin and paclitaxel alone in patients with metastatic mucosal melanoma, according to findings from a phase 2 study published in the Journal of Clinical Oncology.

“Mucosal melanoma is a highly vascularized tumor with an extremely poor prognosis,” the study authors wrote. “The (Avastin with paclitaxel and carboplatin) protocol could be an alternative for the treatment of advanced (mucosal melanoma) in immunotherapies-ineligible or immunotherapies-failure population.”

Researchers studied a total of 114 patients (with previously untreated advanced mucosal melanoma who were randomly assigned treatment with (38 patients) or without Avastin (76 patients), in addition to carboplatin plus paclitaxel (two kinds of chemotherapy). Both carboplatin and paclitaxel were administered every four weeks. Patients assigned Avastin were given the drug once every two weeks.

The primary end point was PFS, with secondary end points including objective response rate, OS and side effects.

Patients assigned Avastin combined with carboplatin and paclitaxelhad a significantly longer PFS compared with those assigned carboplatin plus paclitaxel (4.8 months versus 3 months). Patients who received the Avastin combination also had a significantly longer OS at 13.6 months compared with 9 months for those who did not receive Avastin. Results demonstrated an objective response rate of19.7% for those who received Avastin and 13.2% for those who did not.

Only mild to moderate side effects were seen, with the most common being neutropenia, or a decrease in white blood cells, which was seen in both treatment groups.

“A larger phase 3 study will be necessary to confirm the benefit of adding (Avastin) to carboplatin plus paclitaxel in these settings,” the study authors conclude.

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