Zirabev (bevacizumab-bvzr)

Reviewed by: HU Medical Review Board | Last updated: July 2022

ZirabevTM (bevacizumab-bvzr) is an approved biosimilar to Avastin® (bevacizumab), manufactured by Pfizer. Like Avastin®, ZirabevTM has been approved to treat multiple different types of cancer, including unresectable, locally advanced, recurrent or metastatic (has spread to other parts of the body) non-squamous non-small cell lung cancer (NSCLC); metastatic colorectal cancer; recurrent glioblastoma; metastatic renal cell carcinoma; persistent, recurrent or metastatic cervical cancer; primary peritoneal, fallopian tube, and epithelial ovarian cancers.1 Depending on the specific type of cancer being treated, ZirabevTM may be used in combination with chemotherapy or as a single therapy.

When used to treat NSCLC, ZirabevTM is given as an intravenous infusion once every three weeks. It is used in combination with the chemotherapeutic drugs carboplatin and paclitaxel.2 ZirabevTM works by slowing the growth of new blood cells by targeting the vascular endothelial growth factor protein.

What is a biosimilar?

Unlike traditional drugs, which are manufactured using a process of adding chemicals in a specific order to make medications, targeted biological agents are made from living cells. While generic drugs can be made by repeating the process that makes traditional medications, manufacturing an exact generic biological agent is impossible.2 Drug manufacturers have worked to create products known as “biosimilars”. These are biological medications that treat conditions the same way, with no meaningful difference, similar to a generic medication. ZirabevTM was tested in approximately 400 patients and found to have no clinically meaningful differences in treatment outcomes than Avastin®.1

Biosimilars work like generic drugs by creating less expensive alternatives, and by creating competition within the drug market to lower prices.2 When medication prices are lowered, more patients can have access to treatments for their diseases.

Does ZirabevTM have side effects?

Like any other medication, ZirabevTM can cause side effects. The most common side effects include:1

  • Nosebleed
  • Headache
  • Increased blood pressure
  • Runny nose
  • Excessive protein in the urine
  • Change in how things taste
  • Dry skin
  • Bleeding
  • Excessive tears in the eyes
  • Back pain
  • Redness or peeling of the skin

These side effects may be troublesome enough to cause some patients to discontinue treatment.1

Other side effects can occur with ZirabevTM. Some of these side effects can be severe, even fatal. They include:1

  • Infusion-related reactions
  • Blood clots in the lungs, veins, and arteries
  • Stomach perforations
  • Surgery and wound healing complications (tell your doctor if you are having surgery soon)
  • Hemorrhage (excessive bleeding)
  • Posterior reversible encephalopathy syndrome (PRES)
  • Congestive heart failure (CHF)
  • Risk of reproductive failure
  • Neutropenia, including neutropenic fever
  • Pneumonitis or lung inflammation

If you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed, talk with your doctor. ZirabevTM can cause harm to a developing fetus and should not be given to women who are pregnant. While receiving ZirabevTM, 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 ZirabevTM treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).

Remember, a physician will only place you on ZirabevTM if they believe that the benefits of being on the medication outweigh the risks of taking the medication. If you experience side effects that interfere with your daily activities, be sure to talk to your doctor. They may be able to prescribe medication to help relieve your side effects or may decide that you may need a different treatment option.

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

Accessible cancer therapies

ZirabevTM and other biosimilars are paving the way for more accessible cancer therapies. As more biosimilars become available, patients should have greater access to certain targeted therapies that are potentially more affordable, while still effective, treatment options for multiple cancer diagnoses.

Patients receiving ZirabevTM 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. Patients should talk to their doctor if they have any questions, or if they have questions regarding their ZirabevTM regimen.

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