title: The use of bevacizumab among women with metastatic breast cancer: a survey on clinical practice and the ongoing controversy.
abstract: BACKGROUND
  The US Food and Drug Administration's (FDA's) recent decision to remove the indication of bevacizumab for metastatic breast cancer (MBC) has fueled a debate in the breast cancer community. We conducted a survey to assess the perception of health care workers involved in the management of women with MBC on the FDA's decision to ascertain how it will affect practice and to determine how bevacizumab is commonly used in the community for MBC.
  
  
  METHODS
  E-mails were sent out between September and November 2010 using a database of 3000 addresses maintained by the United Arab Emirates Cancer Congress. Individuals working for Roche or Genentech were excluded. The survey consisted of 22 questions that were divided into 3 parts addressing each participant's demographic profile, their opinion of the FDA's decision, and the typical use of bevacizumab in the community in the setting of MBC.
  
  
  RESULTS
  A total of 564 participants were included in the final analysis, contributing to an 18.8% response rate. Of these participants, 14.6% were from the United States, 7.8% were from Canada, 31.1% were from Europe, 2.0% were from the United Arab Emirates, 11.1% were from Asia, and 33.3% were from other countries. The majority of participants believed progression-free survival to be a surrogate for overall survival, that cost played a role in the FDA's decision, and that the decision would adversely affect the future of newer drugs currently being investigated for MBC. The majority of participants indicated that they would use bevacizumab for triple receptor-negative MBC (46.5%), would use it in a first-line setting (44.7%), and would use it in combination with paclitaxel (51.9%).
  
  
  CONCLUSIONS
  Our survey results highlight the discord between the opinion of community oncologists and the FDA's recent decision to withdraw the indication of bevacizumab for MBC.
authors.affiliation: Department of Medical Oncology, Dubai Hospital, Dubai, United Arab Emirates. shaheenah_@yahoo.com
authors.forename: Shaheenah
authors.initials: S
authors.lastname: Dawood
authors.forename: Asim Jamal
authors.initials: AJ
authors.lastname: Shaikh
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: Javier
authors.initials: J
authors.lastname: Cortes
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristofanilli
authors.forename: Sudeep
authors.initials: S
authors.lastname: Gupta
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Angulo
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017277:Drug Approval; D004363:Drug Utilization; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab