The document discusses the drug Avastin and challenges facing its manufacturer Roche/Genentech. It summarizes that while Avastin provides significant benefits to some cancer patients, recent clinical trials found only small average survival benefits or no survival benefits at all for some cancer types. As a result, government agencies and insurers are challenging Roche/Genentech to develop predictive biomarkers to identify the patients most likely to benefit from Avastin treatment. The manufacturer has tested over 150 potential biomarkers but has yet to find effective ones, which could impact patients and the drug's position in personalized cancer treatment.