Avastin

Metastatic colorectal cancer (with IV 5-FU-based chemotherapy); Non-squamous non-small cell lung cancer (with carboplatin and paclitaxel, first-line); Recurrent glioblastoma; Metastatic renal cell carcinoma (with interferon alfa); Cervical cancer (persistent, recurrent, or metastatic, with chemo); Epithelial ovarian, fallopian tube, or primary peritoneal cancer (multiple settings); Hepatocellular carcinoma (with atezolizumab)

Colorectal cancer: 5 mg/kg or 10 mg/kg IV q2w depending on regimen
Lung cancer: 15 mg/kg IV q3w
Glioblastoma: 10 mg/kg IV q2w
Renal cell: 10 mg/kg IV q2w
First infusion: Over 90 min; may shorten to 30 min if tolerated

Injection: 25 mg/mL solution in 4 mL (100 mg) and 16 mL (400 mg) single-dose vials

Refer to the complete prescribing information for contraindications. Avastin prescribing should account for patient-specific factors including hypersensitivity to the active ingredient or any excipients.

• Gastrointestinal Perforations: Reported in up to 3.2% of patients. Discontinue permanently.
• Surgery and Wound Healing Complications: Do not initiate for at least 28 days after major surgery.
• Hemorrhage: Fatal pulmonary hemorrhage in NSCLC patients. Do not administer for serious hemorrhage.
• Arterial Thromboembolic Events: Increased risk of stroke, MI, TIA.
• Hypertension: Occurs in up to 42% of patients.
• Proteinuria: Monitor with urinalysis.
• Posterior Reversible Encephalopathy Syndrome (PRES)

Hypertension (42%), proteinuria (33%), epistaxis (32%), headache (24%), taste alteration (14%), diarrhea (21%), stomatitis (14%)

Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.

Consult the complete prescribing information for drug interactions, including effects on CYP enzymes, transporters, and concomitant medications that may require dose adjustments or monitoring.

Consult the full prescribing information for pregnancy-related considerations.

Refer to prescribing information for lactation guidance.

Pediatric safety and efficacy information is detailed in the full label.

Dose modifications for organ impairment are specified in the complete prescribing information.

Bevacizumab is a recombinant humanized IgG1 monoclonal antibody that binds to vascular endothelial growth factor (VEGF), preventing its interaction with VEGF receptors (Flt-1 and KDR) on endothelial cells. This inhibits tumor angiogenesis, reducing tumor blood supply and growth.

Half-life: approximately 20 days (range 11-50 days). Clearance: 0.23 L/day. Vd: 2.7-3.2 L. Steady-state at ~100 days. No significant metabolism (IgG catabolism).

Clinical efficacy and safety data supporting the approval are available in the full prescribing information and from the clinical trials listed below.

• AVF2107g — Bevacizumab + IFL vs. IFL alone in 1L metastatic colorectal cancer. Phase III, n=813.
  🔬 NCT00109070 ↗ 📄 Primary Publication ↗
• E4599 — Bevacizumab + carboplatin/paclitaxel vs. chemo alone in advanced nonsquamous NSCLC. Phase III, n=878.
  🔬 NCT00021060 ↗ 📄 Primary Publication ↗

Avastin has FDA-approved indications across the following cancer types covered on PipelineEvidence: