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THE MAGNIFIER Issue #40, February 22, 2006
Newsletter from the Macular Degeneration Foundation, Inc.
P.O. Box 531313 Henderson, NV 89053
http://www.eyesight.org
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CANCER DRUG TREATS MACULAR DEGENERATION
Savannah Doctor Sees Positive Results From Avastin Injections On About 15 Macular Degeneration Patients. Article by Anne Hart
"Anne Silberman of Skidaway Island had a colon
cancer chemo drug injected into her eye to fight, not cancer, but macular degeneration. The 72-year-old widow is among an increasing number of people at risk for central vision loss who are trying Avastin, a cancer drug that
inhibits the growth of new blood vessels.
Eye-care doctors nationally are using the drug even though it was originally approved by the U.S. Food & Drug Administration for the treatment of metastatic colorectal cancer,
and later to fight other types of cancer. Avastin is not approved to treat macular degeneration, which occurs when new blood vessels grow, leak and lead to bleeding in the eye, causing vision loss. And no large safety and
effectiveness studies have been done (for use of) the drug as a treatment for degenerative eye disease.
So patients such as Silberman are taking a risk to see better. The risk is worth it, Silberman said, if Avastin gives
her a few more years of being able to see her grandchildren and to read. 'I would do almost anything to preserve my vision,' Silberman said.
There are two forms of macular degeneration. The wet form is a more
aggressive type - responsible for most cases of severe vision loss - but less common than the more gradual dry type.
In the past two months, Savannah retina specialist Dr. Charles Harris at Southern Retina has injected
Avastin directly into the eyes of about 15 wet macular degeneration patients. He administers Avastin as an ''off-label'' use, meaning the drug was approved to treat a different condition. Harris said his Avastin
patients, including Silberman, have improved as far as drying up the blood vessels.
'It's a major breakthrough for us because other treatments have stabilized patients, or they slowly get worse. Only a small percentage got
better,' Harris said. 'But with this, we have a high rate of improvement.
Silberman tried conventional treatments after she was diagnosed with wet macular degeneration in her left eye eight years ago. She
initially had laser treatment, which destroys the encroaching blood vessels. The procedure left her with a blind spot and only peripheral vision in her left eye. This summer, she began seeing vertical wavy lines in her right
eye, a sign that bleeding had started in that eye, too. Harris used a new, but clinically-tested injection on Silberman called Macugen. It targets the chemicals triggering abnormal blood vessel growth and leakage and reduces, but
doesn't stop, vision loss. Macugen stabilized Silberman's vision for a while, but then it started failing again. After one injection of Avastin, four weeks ago, she is seeing better results. She said she saw an
improvement five days after the shot.
'I am not seeing near the wavies that I normally see,' Silberman said. 'Faces are blurred from a far. But they are better than they were. And with my glasses on I can see faces on the
TV.'
The cost of Avastin is less expensive than approved eye drugs. Macugen, covered by Medicare and given every six weeks, costs $1,000 per injection. It's given about nine times a year per patient. Avastin costs about $60
per injection at Harris' practice and is not covered by Medicare. Harris said he educates patients about Avastin, tells them it is unapproved for this use, and gives them other options.
Warnings about Avastin,
which include an increased risk of stroke and heart attack, pertain to when it is used intravenously on cancer patients. The dose for macular degeneration patients is 400 times smaller than when given intravenously, Harris
said. 'We don't know if there are any long term side effects (from Avastin),' Harris said. 'But we don't think so because it is so similar to the other drugs and it's also being delivered just to the eye.'
Genetech , the original manufacturers of the drug, has developed a macular degeneration drug based on Avastin called Lucentis. It has not yet been approved by the FDA, although clinical trials have shown 40 percent of
patients achieved at least 20/40 vision, WebMD reports. Lucentis injections are expected to range from $12,000-$16,000 a year when the drug hits the market.
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Avastin for Wet AMD?
by Dan Roberts (www.mdsupport.org) October 19, 2005
"As a treatment for wet AMD, off-label use of Avastin is quickly replacing Macugen, due to its more impressive success rate and lower cost. As
"off-label" use, however, there is concern about the safety and purity of the drug.
Phil Rosenfeld, M.D. (who is leading the study of Avastin for retinal treatment at the Bascom Palmer Eye Institute in Miami) told
MD Support that the issue of purity is not a problem in his work. His lab takes every precaution to have the drug safely divided into the desired dosages for injection, and they have had no safety issues so far. The other concerns,
he said, are theoretical, not having presented themselves as problems in actual practice.
In order to develop Avastin into a safe and effective drug for wet AMD, Genentech says that they would have to start at the
pre-clinical trial stage. Considering the involvement of time (5-7 years), they maintain that such an effort would be fruitless when Lucentis is already in place and proving its value.
Regarding of the large cost difference
between the two drugs, the company holds that it should not be a serious concern, as they expect the treatment to be fully-accepted by insurance and Medicare after approval. Genentech also has in place their 'Access to Care'
foundation to provide financial assistance to patients if needed".
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CONTACTING MDF
To speak to a support representative directly, you may call
1-888-633-3937. If you reach our voice mail, please speak slowly and distinctly.
ORDERING BOOKS & TAPES
When purchasing items from Amazon.com, please remember to use the MDF search box located at
http://www.eyesight.org/Books/books.html . By simply originating your search from our website, Amazon rewards the Foundation with a small commission from each product you order. Thank you.
MAKING CONTRIBUTIONS:
Please make checks payable to Macular Degeneration Foundation, Inc., P.O. Box 531313, Henderson, Nevada 89053, or you may use your credit card on our web site http://www.eyesight.org/Donations/donations.html . Your
contributions make our services available as a support system for macular degeneration patients in the following ways:
1. We provide toll-free lines for personal contact assistance.
2. We mail brochures and other printed materials upon request.
3. We support an award-winning web site that provides the latest up-to-date information.
4. We fund research proposal grants to provide therapies for both the wet
and dry form of AMD. Contributions marked "research" are used 100% for research.
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MDF was founded in 1992 by Edmund J. Aleksandrovich Ph.D (a victim of macular
degeneration). It provides MD patients and their families with the information necessary to understand the disease, the latest news concerning ways to cope with the disease, and supports the efforts of researchers to find a
cure.
Subscribers who wish to cancel their subscription or change their email address may visit: http://www.eyesight.org/Newsletter/newsletter.html .
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