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Bevacizumab Brand Names
Avastin | MVASI | Zirabev
What is Bevacizumab
Bevacizumab is a vascular endothelial growth factor (VEGF)-directed monoclonal antibody.
Vascular targeting therapies are aimed at inhibiting tumor neovascularization and are not directly cytotoxic; therefore, bevacizumab is typically used in combination with traditional cytotoxic treatment modalities.
Bevacizumab is indicated for the treatment of colorectal cancer; non-small cell lung cancer; glioblastoma; renal cell carcinoma; cervical cancer; and epithelial ovarian, fallopian tube, or primary peritoneal cancer. It is not indicated for adjuvant treatment of colon cancer.
Bevacizumab-awwb and bevacizumab bvzr, both biosimilars, are FDA-approved for the same indications as bevacizumab, with the exception that they are not approved for use in epithelial ovarian, fallopian tube, or primary peritoneal cancer.
Bevacizumab has been studied as an intravitreal injection for diabetic retinopathy and the wet form of age-related macular degeneration (AMD), as a cost-effective alternative when patients are not responsive to other therapies.
In 2008, bevacizumab with paclitaxel was granted FDA-approval for previously untreated metastatic HER2-negative breast cancer based on an improvement in progression-free survival; however, an improvement in overall survival was not demonstrated.
The FDA rescinded this approval in 2011 after reviewing the results of 4 clinical studies of bevacizumab in breast cancer and determining a lack of prolonged overall survival and a lack of sufficient benefit in slowing disease progression relative to the significant risks of the drug.
Bevacizumab is associated with potentially severe infusion-related reactions; a reduced infusion rate, interruption of therapy, or discontinuation of therapy may be necessary.
Additionally, patients should not receive bevacizumab for 28 days before and after elective surgery due to wound healing complications associated with treatment.
Indications
- breast cancer
- cervical cancer
- colorectal cancer
- diabetic macular edema
- diabetic retinopathy
- glioblastoma multiforme
- macular degeneration
- mesothelioma
- non-small cell lung cancer (NSCLC)
- ovarian cancer
- renal cell cancer
Side Effects
- abdominal pain
- acne vulgaris
- amenorrhea
- angina
- anorexia
- antibody formation
- anxiety
- arthralgia
- asthenia
- back pain
- biliary fistula
- bladder fistula
- bleeding
- blurred vision
- bowel necrosis
- bronchopleural fistula
- chest pain (unspecified)
- chills
- confusion
- constipation
- cough
- dehydration
- diaphoresis
- diarrhea
- dizziness
- dysarthria
- dysphonia
- dyspnea
- elevated hepatic enzymes
- encephalopathy
- epistaxis
- exfoliative dermatitis
- fatigue
- gastritis
- gastroesophageal reflux
- gastrointestinal fistula
- GI bleeding
- GI perforation
- gingivitis
- headache
- hearing loss
- heart failure
- hematemesis
- hematoma
- hemoptysis
- hemorrhoids
- hyperglycemia
- hyperkalemia
- hypertension
- hypertensive crisis
- hypoalbuminemia
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- ileus
- impaired wound healing
- infection
- infusion-related reactions
- insomnia
- intracranial bleeding
- lacrimation
- lethargy
- leukopenia
- lymphopenia
- metallic taste
- myalgia
- myocardial infarction
- nasal septum perforation
- nausea
- necrotizing fasciitis
- nephrotic syndrome
- neutropenia
- neutropenia
- oral ulceration
- osteonecrosis
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- pancytopenia
- pelvic pain
- peptic ulcer
- peripheral edema
- peripheral neuropathy
- pneumonitis
- proteinuria
- pulmonary embolism
- pulmonary hypertension
- rhinitis
- rhinorrhea
- seizures
- sinusitis
- stomatitis
- stroke
- syncope
- thrombocytopenia
- thromboembolism
- thrombosis
- thrombotic microangiopathy
- tinnitus
- tracheoesophageal fistula
- vaginal bleeding
- vaginal fistula
- visual impairment
- vomiting
- weakness
- weight loss
- wheezing
- xerosis
Monitoring Parameters
- blood pressure
- urinalysis
Contraindications
- angina
- bleeding
- breast-feeding
- children
- contraception requirements
- dental work
- diabetes mellitus
- encephalopathy
- fistula
- geriatric
- GI bleeding
- GI obstruction
- GI perforation
- heart failure
- hypertension
- hypertensive crisis
- impaired wound healing
- infants
- infertility
- infusion-related reactions
- intracranial bleeding
- myocardial infarction
- neonates
- ovarian cancer
- ovarian failure
- pregnancy
- proteinuria
- radiation therapy
- renal impairment
- reproductive risk
- stroke
- surgery
- thromboembolic disease
- vaginal bleeding
Interactions
- Palifermin
- Panitumumab
- Penicillamine
- Solriamfetol
- Tuberculin Purified Protein Derivative, PPD
