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What is Zirabev (bevacizumab-bvzr)?

The United States Food and Drug Administration recently approved an Avastin (bevacizumab) biosimilar, Zirabev (bevacizumab-bvzr), manufactured by Pfizer. Like Avastin, Zirabev has been approved to treat five different types of cancer: unresectable, locally advanced, recurrent or metastatic non-squamous non-small cell lung cancer (NSCLC); metastatic colorectal cancer; recurrent glioblastoma; metastatic renal cell carcinoma; and persistent, recurrent or metastatic cervical cancer.1 Zirabev can be used in combination with chemotherapy or as a single therapy to treat these cancers.

When used to treat NSCLC, Zirabev is given as an intravenous infusion once every three weeks. It is used in combination with the chemotherapeutic drugs carboplatin and paclitaxel.2 Zirabev 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. Zirabev was tested in over 400 patients and found to be no different 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 Zirabev have side effects?

Like any other medication, Zirabev can cause side effects. The most common side effects are:1

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

These side effects can cause some patients to discontinue treatment. Approximately 10-25% of patients discontinued treatment with Zirabev due to side effects.1

Other side effects can occur with Zirabev. 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 (patients who have elective surgery while on Zirabev should not receive treatment for 28 days prior to and after surgery)
  • Hemorrhage (excessive bleeding)
  • Posterior reversible encephalopathy syndrome (PRES)
  • Congestive heart failure (CHF)
  • Risk of reproductive failure
  • Neutropenia, including neutropenic fever
  • Pneumonitis or lung inflammation

In addition, women who are taking Zirabev should not get pregnant while being treated, and for at least 6 months after treatment due to risk to the fetus.

Remember, a physician will only place you on Zirabev 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.

Accessible cancer therapies

Zirabev and other biosimilars are paving the way for more accessible cancer therapies. As more biosimilars become available, patients should have greater access to affordable, targeted care that has the opportunity to give them a safer, more effective treatment for multiple cancer diagnoses.

Last reviewed: October 2019
  1. Pfizer Receives U.S. FDA Approval for Its Oncology Biosimilar, ZIRABEV™ (bevacizumab-bvzr) | Pfizer. Pfizer.com. https://www.pfizer.com/news/press-release/press-release-detail/pfizer_receives_u_s_fda_approval_for_its_oncology_biosimilar_zirabev_bevacizumab_bvzr. Published 2019. Accessed September 1, 2019.
  2. Astor L. FDA Approves Bevacizumab Biosimilar Zirabev. Targeted Oncology. https://www.targetedonc.com/news/fda-approves-bevacizumab-biosimilar-zirabev. Published 2019. Accessed September 1, 2019.
  3. Zirabev (bevacizumab-bvzr) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/761099s000lbl.pdf Accessed September 1, 2019.