Example orders for Vinorelbine and Bevacizumab in breast cancer

Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

Vinorelbine & Bevacizumab

Published regimens and references can be found on the breast cancer page.

Example order set #1

• Vinorelbine (Navelbine) 25 mg/m² IV push once per day on days 1, 8, 15
• Bevacizumab (Avastin) 10 mg/kg IV over 30 to 90 minutes (first dose should be over 90 minutes, and if tolerated, subsequent doses can be given over 30 minutes) once per day on days 1 & 15

28-day cycles

Supportive therapy

• Ondansetron (Zofran) 8 mg PO once; 30 minutes prior to chemotherapy
• Optional: Prochlorperazine (Compazine) 10 mg PO once prn nausea prior to chemotherapy

Hydration:

• Normal saline IV continuous infusion at 5 mL/H
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Monitoring/precautions:

• For cycle 1, check blood pressure before, during, and after bevacizumab infusion. For subsequent cycles, check blood pressure before and after bevacizumab.
• Check urine dipstick for protein every 30 days; notify physician if protein ≥100 mg/dL

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.