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Avastin (bevacizumab)

Avastin® is a targeted therapy that is used to treat 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 patients with non-squamous NSCLC who have not previously received chemotherapy for their disease. 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), 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 other components in the immune system. Monoclonal antibodies 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 30% of patients taking 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 10-29% 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 (this is not a complete list of adverse effects).2

Precautions

Patients receiving bevacizumab should talk to their doctor about other medications, herbal remedies, and any supplements they are taking, as well as any other health conditions. Patients should talk to their doctor before receiving immunizations or vaccinations while taking bevacizumab to make sure they are appropriate. Patients who are pregnant or may become pregnant during treatment should discuss their condition with their doctor prior to starting bevacizumab, as it may be hazardous to the fetus. It is not recommended for men or women to conceive a child while taking bevacizumab, and patients are advised to use barrier methods of contraception (i.e. condoms). It is not known whether bevacizumab passes into breast milk, and patients should not breastfeed while taking bevacizumab.2

Written by: Emily Downward | Last reviewed: April 2019.
  1. Avastin product website, Genentech, Inc. Accessed online on 9/28/16 at http://www.avastin.com/.
  2. Chemocare. Accessed online on 9/28/16 at http://chemocare.com/chemotherapy/drug-info/avastin.aspx.