VEGF-Trap

[Ritalisa]

I'm searching for someone that has been a clinical trial of VEGF-Trap. I want to hear about side effects, results, etc. I have to decide if I'm going to do the 2nd phase of the trial.
Thanks.

[gpawelski]

VEGF Trap blocks the action of vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels needed for tumors to grow (vascular endothelial grwoth factor trap). It is a type of angiogenesis inhibitor.

VEGF-targeted drug may have the potential to improve the efficacy of standard combination chemotherapy in ovarian cancer. Studies have investigated the activity of novel medications (like VEGR-targeted drugs) in combination with standard therapy to improve overall and disease-free survival in ovarian cancer patients.

Tumor growth is dependent on angiogenesis. Angiogenesis is dependent on vascular endothelial growth factor (VEGF). Anti-angiogenesis drugs work by blocking the activity of VEGF to prevent the growth of new capillaries into the tumor and thereby sustain tumor growth. A anti-angiogenesis type drug directly binds to VEGF to directly inhibit angiogenesis, by choking off the blood vessels that provide a tumor with oxygen and nutrients. Tumors which secrete relatively low levels of VEGF, might be more susceptible to an agent which works by blocking VEGF.

However, all the VEGF mutation or amplification studies can tell us is whether or not cells are potentially susceptible to this mechanism of attack. They don't tell you if one of the drugs is better or worse than some other drug which may target this. VEGF-targeted drugs are poorly-predicted by measuring the indicated target. It would be more beneficial if they measured the effect of any drug on the function of your live cells.

In cancer medicine, it's not a case of throwing targeted drugs at the problem. It's knowing "what" targeted drugs and "how" to use them in "individual" patients, not "average population" clinical trials.

A patient can receive a genetic test for VEGF mutation or amplification. However, it can only tell us if or not cells are potentially susceptible to this mechanism of attack. It cannot tell you if one of the drugs is better or worse than some other drug which may target this. These tests are never done in the presence of anti-cancer drugs.

However, cell-based assay testing for VEGF does test in the presence of anti-cancer drugs. Instead of blindly mixing and matching drugs to individual cancer patients, what would be more beneficial is to sort out what's the best profile in terms of which patients benefit from this drug or any other drug. Can they be combined? What's the proper way to work with these new drugs?

More importantly, if a drug works extremely well for a certain percentage of cancer patients, identify which ones. If one drug or another is working for some people (not average populations like in clinical trials) then obviously there are others out there who would also benefit. What's good for the group (population) may not be good for the individual.

If "targeted" drugs either won't "get in" in the first place or if it gets pumped out/extruded or if it gets immediately metabolized inside the cell, it just isn't going to work. Upgrading clinical therapy by using drug sensitivity assays measuring "cell-death" of three dimensional microclusters of live "fresh" tumor cells, can improve the situation by allowing more drugs to be considered.

The more drug types there are in the selective arsenal, the more likely the system is to prove beneficial. Drug sensitivity tests support the idea that a marginal benefit in terms of overall survial is observed in cancer patients with normal prognoses, but there are marked survival benefits for cancer patients with poor prognoses.

I think that every cancer patient would want to have their own unique chemotherapy based on consultation of pathogenic profiles and drug sensitivity testing data. Having some foreknowledge of a given agent's expected result before its administration would benefit the individual patient.

[Ritalisa]

Thank you for the info. I was fortunate to find one lady on ACOR that had done phase 1 of the trial. I'm just hoping to talk with others that have done it. I want to hear about results and side effects.