A collaborative team of researchers led by Case Western Reserve University have made an important breast cancer research discovery. They've found that a targeted therapy for treating some forms of breast cancer is effective in predicting early-on whether the drug bevacizumab, known commercially as Avastin, will be or will not be effective in individual patients.

The FDA rescinded its approval of Avastin for breast cancer in 2011 after it determined the drug did not improve survival rates. While the drug is still being used in Europe with some success, researchers and scientists at CWRU, Brown University, Yale University, and Philips Research North America worked to determine whether they could tell early whether Avastin might work or whether the medication’s significant toxicity would cause harm without much effect on treating the cancer.

Vinay VaradanThey found that just one dose of Avastin, given upon initial diagnosis, could show whether the drug would be effective. “We thought if that one dose would change that tumor in the first 15 days, if it could predict at the very early stage how they would respond, that give us a chance to target treatment,” explains Vinay Varadan, assistant professor of general medicine at the Case Comprehensive Cancer Center, and lead author on the team’s findings presented in the International Journal of Cancer.

“I think it’s pretty exciting. With just one dose we might be able to figure out who it might help. It will help us personalize therapies for the patient.”

While additional clinical trials are needed to determine if this approach is effective, Varadan says the more important point in these findings is that it is a step forward for finding targeted therapies for breast cancers that have not responded well to other targeted treatments – specifically, what is known as Triple Negative cases. Triple Negative cancer cells do not have receptors for estrogen, progesterone, or HER2 -- 10 to 20 percent of all breast cancers.

"Now we have a framework we can use,” says Varadan. “It’s exciting. The framework seems to be effective across cancers and can speed up the process in finding biomarkers.” Identifying biomarkers can help find more targeted treatments.

Now Varadan and his team are working with Case's biomedical engineering department to determine if an MRI could be used to identify whether the Avastin will be effective, as opposed to the second biopsy now needed.

“This becomes even more exciting because MRI imaging would be non-invasive than running a second biopsy after treatment,” Varadan says.

The CWRU team on this research included principal investigator and senior author Lindsay Harris with University Hospitals Seidman Cancer Center, Hannah Gilmore in the department of pathology, and Ajay Basavanhalli in the biomedical engineering department.