Difference between revisions of "Bevacizumab (Avastin)"

Revision as of 22:00, 27 November 2018

General information

Class/mechanism: Monoclonal antibody that inhibits angiogenesis by binding VEGF and preventing the interaction of VEGF with its receptors (Flt-1 and KDR) on the surface of endothelial cells.^[1]^[2]^[3]
Route: IV
Extravasation: neutral

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape,UpToDate (courtesy of Lexicomp), or the prescribing information.^[1]

Diseases for which it is used

Information about counterfeit bevacizumab

FDA's 2/14/2012 statement about counterfeit Avastin in U.S.
Genentech's 2/14/2012 statement on counterfeit drug labeled as Avastin (Bevacizumab) in the United States - contains pictures of authentic and counterfeit product
Authorized specialty distributors, wholesalers and specialty pharmacies for Bevacizumab (Avastin)

Patient drug information

Bevacizumab (Avastin) patient drug information (Chemocare)^[4]
Brief patient counseling information can be found in the package insert^[1]
Bevacizumab (Avastin) patient drug information (UpToDate)^[5]

History of changes in FDA indication

Breast cancer

2/22/2008: Granted accelerated approval for use in combination with paclitaxel for the treatment of patients who have not received chemotherapy for metastatic HER2 negative breast cancer. (New disease entity)

Cervical cancer

8/14/2014: Approved for treatment of cervical cancer, in combination with paclitaxel and cisplatin or paclitaxel and topotecan in persistent, recurrent, or metastatic disease. (New disease entity)

Colorectal cancer

2/26/2004: Initial FDA approval, in combination with intravenous 5-fluorouracil–based chemotherapy...for first- line treatment of patients with metastatic carcinoma of the colon or rectum.
6/20/2006: Approved for second-line treatment of metastatic carcinoma of the colon or rectum. (New treatment setting without requirement for combination therapy)

Glioblastoma

5/5/2009: Granted accelerated approval as a single agent for patients with glioblastoma, with progressive disease following prior therapy. (New disease entity)

Non-small cell lung cancer

10/11/2006: Approved as a first-line treatment of patients with locally advanced, metastatic or recurrent non-small cell lung cancer in combination with platinum-based chemotherapy. (New disease entity)
- Non-squamous non-small cell lung cancer, with carboplatin and paclitaxel for first line treatment of unresectable, locally advanced, recurrent or metastatic disease. (Label restricted to non-squamous histology only)

Ovarian cancer

11/14/2014: Approved for treatment of platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer, in combination with paclitaxel, pegylated liposomal doxorubicin or topotecan. (New disease entity)
6/13/2018: Approved for patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with carboplatin and paclitaxel, followed by single-agent bevacizumab, for stage III or IV disease after initial surgical resection. (Indication expanded to first-line setting)

Other (unsorted)

- Metastatic colorectal cancer, with intravenous 5-fluorouracil–based chemotherapy for first- or second-line treatment.
- Metastatic colorectal cancer, with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy for second-line treatment in patients who have progressed on a first-line Avastin containing regimen.
- Metastatic renal cell carcinoma with interferon alfa.

Also known as

Generic name: rhuMab-VEGF
Brand names: Altuzan, Avastin, BevaciRel, Bevarest

References

[insert-1] 1.0 ^1.1 ^1.2 Bevacizumab (Avastin) package insert

[2] Bevacizumab (Avastin) package insert (locally hosted backup)

[3] Avastin manufacturer's website

[4] Bevacizumab (Avastin) patient drug information (Chemocare)

[5] Bevacizumab (Avastin) patient drug information (UpToDate)

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@@ Line 51: / Line 51: @@
 *'''2/26/2004: [http://www.accessdata.fda.gov/drugsatfda_docs/appletter/2004/125085ltr.pdf Initial FDA approval]''', in combination with intravenous [[Fluorouracil (5-FU)|5-fluorouracil]]–based chemotherapy...for first- line treatment of patients with metastatic carcinoma of the [[Colon_cancer|colon]] or [[Rectal_cancer|rectum]].
 *6/20/2006: Approved for second-line treatment of metastatic carcinoma of the [[Colon_cancer|colon]] or [[Rectal_cancer|rectum]]. ''(New treatment setting without requirement for combination therapy)''
+===[[Glioblastoma]]===
+*5/5/2009: Granted accelerated approval as a single agent for patients with [[glioblastoma]], with progressive disease following prior therapy. ''(New disease entity)''
 ===[[Non-small cell lung cancer]]===
@@ Line 63: / Line 66: @@
 **Metastatic [[Colon_cancer|colorectal cancer]], with intravenous [[Fluorouracil (5-FU)|5-fluorouracil]]–based chemotherapy for first- or second-line treatment.
 **Metastatic [[Colon_cancer|colorectal cancer]], with [[Fluorouracil (5-FU)|fluoropyrimidine-]][[Irinotecan (Camptosar)|irinotecan-]] or [[Fluorouracil (5-FU)|fluoropyrimidine-]][[Oxaliplatin (Eloxatin)|oxaliplatin-]]based chemotherapy for second-line treatment in patients who have progressed on a first-line Avastin containing regimen.
-**[[Central_nervous_system_(CNS)_cancer|Glioblastoma]], as a single agent for adult patients with progressive disease following prior therapy.
 **Metastatic [[Renal_cell_carcinoma|renal cell carcinoma]] with [[Interferon alfa-2a (Roferon-A)|interferon alfa]].