Prab at 13:47, 26 March 2025

2025-03-26T13:47:46Z

← Older revision		Revision as of 13:47, 26 March 2025
Line 2:		Line 2:

	* Bevacizumab ('''Avastin''') is '''a vascular endothelial growth factor inhibitor''' used alone or with other drugs to treat certain types of cervical, colorectal, lung, and kidney cancer, and [[glioblastoma]] (a type of brain cancer).		* Bevacizumab ('''Avastin''') is '''a vascular endothelial growth factor inhibitor''' used alone or with other drugs to treat certain types of cervical, colorectal, lung, and kidney cancer, and [[glioblastoma]] (a type of brain cancer).


	[[File:Angiogenesis Inhibitors Image.tiff\|thumb\|Angiogenesis Inhibitors Image]]		[[File:Angiogenesis Inhibitors Image.tiff\|thumb\|Angiogenesis Inhibitors Image]]


	~~<youtube>~~
	~~title='''{{PAGENAME}}'''~~
	~~movie_url=http://www.youtube.com/v/v=006fVhPGF-4~~
	~~embed_source_url=http://www.youtube.com/v/v=006fVhPGF-4~~
	~~&rel=1~~
	~~wrap = yes~~
	~~width=750~~
	~~height=600~~
	~~</youtube>~~

	== '''What are the uses of this medicine?''' ==		== '''What are the uses of this medicine?''' ==
Line 147:		Line 135:

	* The safety and effectiveness of Avastin in pediatric patients have not been established.		* The safety and effectiveness of Avastin in pediatric patients have not been established.


	== '''What are the active and inactive ingredients in this medicine?''' ==		== '''What are the active and inactive ingredients in this medicine?''' ==

Prab at 19:20, 9 September 2023

2023-09-09T19:20:36Z

New page

== '''What is Bevacizumab?''' ==

* Bevacizumab ('''Avastin''') is '''a vascular endothelial growth factor inhibitor''' used alone or with other drugs to treat certain types of cervical, colorectal, lung, and kidney cancer, and [[glioblastoma]] (a type of brain cancer).

[[File:Angiogenesis Inhibitors Image.tiff|thumb|Angiogenesis Inhibitors Image]]

<youtube>
title='''{{PAGENAME}}'''
movie_url=http://www.youtube.com/v/v=006fVhPGF-4
embed_source_url=http://www.youtube.com/v/v=006fVhPGF-4
&rel=1
wrap = yes
width=750
height=600
</youtube>

== '''What are the uses of this medicine?''' ==

Bevacizumab (Avastin) is indicated for the treatment of:
* [[Metastatic]] [[colorectal cancer]], in combination with intravenous [[fluorouracil]]-based [[chemotherapy]] for first- or second-line treatment.
* Metastatic colorectal cancer, in combination with [[fluoropyrimidine]]-[[irinotecan]]- or [[fluoropyrimidine]]-[[oxaliplatin]]-based [[chemotherapy]] for second-line treatment in patients who have progressed on a first-line Avastin-containing regimen.
* Unresectable, locally advanced, recurrent or metastatic [[Non-squamous non-small cell lung carcinoma|non-squamous non-small cell lung cancer]], in combination with [[carboplatin]] and [[paclitaxel]] for first-line treatment.
* Recurrent [[glioblastoma]] in adults.
* [[Metastatic renal cell carcinoma]] in combination with [[Interferon|interferon alfa]].
* Persistent, recurrent, or metastatic [[cervical cancer]], in combination with [[paclitaxel]] and [[cisplatin]], or paclitaxel and [[topotecan]].

'''Epithelial ovarian, fallopian tube, or primary peritoneal cancer:'''
* in combination with carboplatin and paclitaxel, followed by Avastin as a single agent, for stage III or IV disease following initial surgical resection.
* in combination with paclitaxel, pegylated liposomal [[doxorubicin]], or [[topotecan]] for [[platinum]]-resistant recurrent disease who received no more than 2 prior [[chemotherapy]] regimens.
* in combination with carboplatin and paclitaxel or carboplatin and [[gemcitabine]], followed by Avastin as a single agent, for platinum-sensitive recurrent disease.

'''Hepatocellular Carcinoma (HCC):'''
* in combination with [[atezolizumab]] for the treatment of patients with unresectable or metastatic HCC who have not received prior systemic therapy.

'''Limitations of Use:'''
* Avastin is not indicated for [[Adjuvant medication|adjuvant]] treatment of [[colon cancer]].

== '''How does this medicine work?''' ==

* Bevacizumab (be” va siz’ ue mab) is '''a recombinant humanized monoclonal IgG1 antibody''' which is directed at and '''binds avidly to circulating vascular endothelial growth factor (VEGF)'''.
* Receptors for VEGF (Flt-1 and KDR) are present on endothelial cells, and the engagement of VEGF with these receptors promotes [[angiogenesis]]. '''Inhibition of VEGF decreases formation of new blood vessels, which plays an important role in growth and spread of cancer cells'''.
* When used in combination with other [[antineoplastic]] agents, bevacizumab has been shown to extend both recurrence-free as well as overall patient survival in several forms of advanced cancer.

== '''Who Should Not Use this medicine ?''' ==

* This medicine have no usage limitations.

== '''What drug interactions can this medicine cause?''' ==

* No clinically meaningful drug interactions have been observed.

== '''Is this medicine FDA approved?''' ==

* Bevacizumab was approved in the United States in 2004 for use in metastatic colon cancer.
* Indications were subsequently extended to selected forms of non-small cell lung cancer, breast and renal cancer and glioblastoma.
* However, the indication for use in breast cancer was withdrawn in 2011 because of lack of evidence that bevacizumab extended overall patient survival.

== '''How should this medicine be used?''' ==

'''Recommended dosage:'''
'''Metastatic colorectal cancer:'''
* 5 mg/kg every 2 weeks with bolus-IFL
* 10 mg/kg every 2 weeks with FOLFOX4
* 5 mg/ kg every 2 weeks or 7.5 mg/kg every 3 weeks with [[fluoropyrimidine]]-[[irinotecan]]- or fluoropyrimidine-[[oxaliplatin]]-based [[chemotherapy]] after progression on a first-line Avastin containing regimen

'''First-line non–squamous non–small cell lung cancer:'''
* 15 mg/kg every 3 weeks with [[carboplatin]] and [[paclitaxel]]

'''Recurrent glioblastoma:'''
* 10 mg/kg every 2 weeks

'''Metastatic renal cell carcinoma:'''
* 10 mg/kg every 2 weeks with [[Interferon|interferon alfa]]

'''Persistent, recurrent, or metastatic cervical cancer:'''
* 15 mg/kg every 3 weeks with [[paclitaxel]] and [[cisplatin]], or paclitaxel and [[topotecan]]

'''Stage III or IV epithelial ovarian, fallopian tube or primary peritoneal cancer following initial surgical resection:'''
* 15 mg/kg every 3 weeks with carboplatin and paclitaxel for up to 6 cycles, followed by 15 mg/kg every 3 weeks as a single agent, for a total of up to 22 cycles

'''Platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer:'''
* 10 mg/kg every 2 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan given every week
* 15 mg/kg every 3 weeks with topotecan given every 3 weeks

'''Platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer:'''
* 15 mg/kg every 3 weeks with carboplatin and paclitaxel for 6-8 cycles, followed by 15 mg/kg every 3 weeks as a single agent
* 15 mg/kg every 3 weeks with carboplatin and gemcitabine for 6-10 cycles, followed by 15 mg/kg every 3 weeks as a single agent

'''Hepatocellular Carcinoma:'''
* 15 mg/kg after administration of 1,200 mg of atezolizumab every 3 weeks

'''Administration:'''
* Administer as an intravenous infusion.

== '''What are the dosage forms and brand names of this medicine?''' ==

This medicine is available in fallowing doasage form:
* '''As Injection:''' 100 mg/4 mL (25 mg/mL) or 400 mg/16 mL (25 mg/mL) in a single-dose vial

This medicine is available in fallowing brand namesː
* '''Avastin''';'''Alymsys''';'''Mvasi''';'''Zirabev'''

=='''What side effects can this medication cause?'''==

The most common side effects of this medicine include:
* [[epistaxis]]
* headache
* [[hypertension]]
* [[rhinitis]]
* [[proteinuria]]
* taste alteration
* dry skin
* [[hemorrhage]]
* lacrimation disorder
* back pain
* [[exfoliative dermatitis]]

==''' What special precautions should I follow?''' ==

* Serious, and sometimes fatal, [[gastrointestinal perforation]] occurred at a higher incidence in patients receiving Avastin compared to patients receiving chemotherapy. Discontinue for gastrointestinal perforations, tracheoesophageal fistula, grade 4 fistula, or [[fistula]] formation involving any organ.
* In patients who experience wound healing complications during Avastin treatment, withhold Avastin until adequate wound healing. Withhold for at least 28 days prior to elective surgery. Do not administer Avastin for at least 28 days following a major surgery, and until adequate wound healing. The safety of resumption of AVASTIN after resolution of wound healing complication has not been established. Discontinue for wound healing complication of necrotizing fasciitis.
* Avastin can result in two distinct patterns of bleeding: minor [[hemorrhage]], which is most commonly Grade 1 [[epistaxis]], and serious hemorrhage, which in some cases has been fatal. Severe or fatal hemorrhages have occurred. Do not administer for recent [[hemoptysis]]. Discontinue for Grade 3-4 hemorrhage.
* Serious, sometimes fatal, [[Arterial thromboembolism|arterial thromboembolic events]] (ATE) including [[cerebral infarction]], [[transient ischemic attacks]], [[myocardial infarction]], and [[angina]], occurred at a higher incidence in patients receiving Avastin compared to patients receiving chemotherapy. Discontinue for severe ATE.
* An increased risk of [[Venous thromboembolism|venous thromboembolic events]] (VTE) was observed across clinical studies. Discontinue for Grade 4 VTE.
* Severe [[hypertension]] occurred at a higher incidence in patients receiving Avastin as compared to patients receiving chemotherapy alone. Monitor blood pressure and treat hypertension. Withhold if not medically controlled; resume once controlled. Discontinue for [[hypertensive crisis]] or [[hypertensive encephalopathy]]
* [[Posterior reversible encephalopathy syndrome]] (PRES) was reported. Discontinue Avastin in patients who develop PRES.
* The incidence and severity of [[proteinuria]] was higher in patients receiving Avastin as compared to patients receiving chemotherapy. Monitor urine protein. Discontinue for [[nephrotic syndrome]]. Withhold until less than 2 grams of protein in urine.
* Infusion-related reactions reported with Avastin. Decrease rate for infusion-related reactions. Discontinue for severe infusion-related reactions and administer medical therapy.
* Avastin may cause fetal harm. Advise females of potential risk to fetus and need for use of effective [[contraception]].
* Based on its mechanism of action and findings from animal studies, Avastin may cause fetal harm when administered to pregnant women. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with Avastin and for 6 months after the last dose.
* Avastin is not indicated for use with anthracycline-based chemotherapy. The incidence of Grade ≥ 3 left ventricular dysfunction was in patients receiving Avastin compared to patients receiving chemotherapy alone. Discontinue Avastin in patients who develop CHF.

== '''What to do in case of emergency/overdose?''' ==

* {{overdose}}

== '''Can this medicine be used in pregnancy?''' ==

* Based on findings from animal studies and its mechanism of action , Avastin may cause fetal harm in pregnant women.
* Advise pregnant women of the potential risk to a fetus.

=='''Can this medicine be used in children?'''==

* The safety and effectiveness of Avastin in pediatric patients have not been established.

== '''What are the active and inactive ingredients in this medicine?''' ==

'''Active ingredients:'''
* BEVACIZUMAB

'''Inactive ingredients:'''
* TREHALOSE DIHYDRATE
* SODIUM PHOSPHATE, MONOBASIC, MONOHYDRATE
* SODIUM PHOSPHATE, DIBASIC, ANHYDROUS
* POLYSORBATE 20
* WATER

== '''Who manufactures and distributes this medicine?''' ==

* '''Manufactured by:'''
[[Genentech, Inc]].
A Member of the Roche Group
1 DNA Way
South San Francisco, CA

* Avastin® is a registered trademark of Genentech, Inc.

== '''What should I know about storage and disposal of this medication?''' ==

* Store refrigerated at 2°C to 8°C (36°F to 46°F) in the original carton until time of use to protect from light.
* Do not freeze or shake the vial or carton.

{{coststubd}}
{{Extracellular chemotherapeutic agents}}
{{Monoclonals for bone, musculoskeletal, circulatory, and neurologic systems}}
{{Growth factor receptor modulators}}
{{Portal bar|Medicine}}
[[Category:Angiogenesis inhibitors]]
[[Category:Genentech brands]]
[[Category:Hoffmann-La Roche brands]]
[[Category:Monoclonal antibodies for tumors]]
[[Category:Orphan drugs]]
[[Category:Specialty drugs]]
[[Category:World Health Organization essential medicines]]

Bevacizumab - Revision history

Prab at 13:47, 26 March 2025

Prab at 19:20, 9 September 2023