Avastin (bevacizumab)

Avastin^® is a targeted therapy that is used to treat some advanced non-squamous non-small cell lung cancers (NSCLC). It is approved to be used in combination with the chemotherapy drugs carboplatin and paclitaxel in certain patients with non-squamous NSCLC as first line treatment. Bevacizumab is also used to treat other cancers, including metastatic colon or rectal cancer, glioblastoma (a certain form of brain cancer), metastatic renal cell carcinoma (a certain form of kidney cancer), hepatocellular carcinoma (a certain form of liver cancer), and may also be used in the treatment of ovarian and cervical cancers.^1,2

Bevacizumab is a targeted therapy that is classified as a monoclonal antibody. Antibodies are a normal part of the immune system that attach to antigens (such as germs) to mark them for destruction by the immune system. Monoclonal antibodies used in cancer treatment are created in a laboratory to attach to specific antigens on the surface of cancer cells. Bevacizumab targets human vascular endothelial growth factor (VEGF), a protein that leads to the new development of blood vessels (a process called angiogenesis). By blocking VEGF, bevacizumab may help shrink the cancer or slow the cancer’s progression.²

Receiving bevacizumab

Bevacizumab is given as an infusion in an IV (intravenous) line. The duration of the infusion is determined by the dose as well as policies in place at the institution where you receive treatment. The dosage is determined by several factors, including the patient’s  weight, general health, and the type of cancer.²

Side effects of bevacizumab

Bevacizumab may cause side effects, and in some cases, these side effects can be severe. Any side effects should be reported to a health care professional. Side effects experienced in greater than approximately 30 percent of patients receiving bevacizumab include generalized weakness, pain, abdominal pain, nausea, vomiting, poor appetite, constipation, upper respiratory infection, low white blood cell count (increasing the risk of infection), proteinuria (protein in the urine), nose bleed, diarrhea, hair loss, mouth sores, and headache. Less common side effects experienced in approximately 10-29 percent of patients receiving bevacizumab include shortness of breath, dizziness, high blood pressure, weight loss, and muscle aches and pains. Rarely, Avastin can cause severe side effects, including gastrointestinal perforation, severe bleeding (hemorrhage), severe high blood pressure, nephrotic syndrome (damage to the kidneys), or congestive heart failure (especially in patients who have received prior treatment with anthracyclines (a certain type of chemotherapy) or radiation therapy to the chest wall). Some side effects caused by bevacizumab require immediate medical attention such as swelling of the feet or ankles, sudden weight gain, abdominal pain, nausea that interferes with the ability to eat and is unrelieved with anti-nausea medication, vomiting (4-5 episodes within 24 hours), diarrhea (4-6 episodes within 24 hours), constipation unrelieved by laxatives, coughing up blood, black or tarry stools, blood in the stool, blood in the urine, mouth sores, signs of infection (redness, swelling, pain on swallowing, coughing up mucus, or painful urination), signs of dehydration (tiredness, dry mouth, dark and decreased urine, or dizziness), or swelling, redness and/or pain in one leg or arm and not the other.²

This is not an exhaustive list of all potential side effects of bevacizumab. Talk to your healthcare provider or pharmacist for further information.

Precautions

Patients receiving bevacizumab should talk to their doctor about any other medications (prescription and over-the-counter), herbal remedies, and any supplements they are taking, as well as any other health conditions. If you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed, talk with your doctor. Bevacizumab can cause harm to a developing fetus and should not be given to women who are pregnant. While receiving bevacizumab, females who can become pregnant should use contraceptives during treatment and for a period of time after completing treatment (patients should discuss appropriate birth control methods, and how long they need to use them, with their doctor). Females should not breastfeed during bevacizumab treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).²