Cancer drug may save sight of premature infants

The anticancer drug bevacizumab could help prevent babies with retinopathy of prematurity from becoming blind, reports a new study from the University of Texas Health Science Center at Houston Medical School.

The randomized trial assigned 150 premature infants with advanced retinal damage in the areas nearest the optic nerve to treatment with either an injection of bevacizumab or with laser surgery. A single injection of the drug into each eye prevented blindness more effectively than laser surgery: of the 75 infants who received bevacizumab, only 6% had a recurrence of retinopathy of prematurity, compared with 42% of babies who underwent laser surgery.

According to researchers, retinopathy of prematurity is caused by uncontrolled growth of blood vessels in the eye, leading to scarring and retinal detachment. Bevacizumab stopped the growth of blood vessels, often with a single injection, whereas laser treatment requires general anesthesia and a breathing tube, often must be repeated, and in many cases, ultimately fails to restore vision.

The trial couldn’t assess the safety of bevacizumab injections because of its small size. However, because so many adults with cancer have been treated with bevacizumab and the dose for infants is very small, “it seems reasonable to assume” that the injections are at least as safe as laser surgery, writes James Reynolds, MD, State University of New York at Buffalo, in an editorial accompanying the study.

Reynolds emphasizes that “the timing of the injection is critical.” An injection given too early may interfere with blood vessel growth; an injection given too late may damage the retina.

The study was published online February 17 in The New England Journal of Medicine.