Difference between revisions of "Bevacizumab (Avastin)"

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*[[Anaplastic glioma]]
 
*[[Anaplastic glioma]]
 
*[[Angiosarcoma]]
 
*[[Angiosarcoma]]
*[[Bladder cancer]]
 
 
*[[Breast cancer]]
 
*[[Breast cancer]]
 
*[[Cholangiocarcinoma]]
 
*[[Cholangiocarcinoma]]
 +
*[[Endometrial cancer]]
 
*[[Esophageal cancer]]
 
*[[Esophageal cancer]]
 
*[[Follicular lymphoma]]
 
*[[Follicular lymphoma]]
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*[[Small cell lung cancer]]
 
*[[Small cell lung cancer]]
 
*[[Testicular cancer]]
 
*[[Testicular cancer]]
*[[Endometrial cancer]]
+
*[[Urothelial carcinoma]]
 
</div>
 
</div>
  
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==Patient drug information==
 
==Patient drug information==
*[https://chemocare.com/chemotherapy/drug-info/bevacizumab.aspx Bevacizumab (Avastin) patient drug information (Chemocare)]<ref>[https://chemocare.com/chemotherapy/drug-info/bevacizumab.aspx Bevacizumab (Avastin) patient drug information (Chemocare)]</ref>
+
*[https://chemocare.com/druginfo/bevacizumab.aspx Bevacizumab (Avastin) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/bevacizumab.aspx Bevacizumab (Avastin) patient drug information (Chemocare)]</ref>
 
*Brief patient counseling information can be found in [http://www.gene.com/download/pdf/avastin_prescribing.pdf the package insert]<ref name="insert"></ref>
 
*Brief patient counseling information can be found in [http://www.gene.com/download/pdf/avastin_prescribing.pdf the package insert]<ref name="insert"></ref>
 
*[http://www.uptodate.com/contents/bevacizumab-patient-drug-information Bevacizumab (Avastin) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/bevacizumab-patient-drug-information Bevacizumab (Avastin) patient drug information (UpToDate)]</ref>
 
*[http://www.uptodate.com/contents/bevacizumab-patient-drug-information Bevacizumab (Avastin) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/bevacizumab-patient-drug-information Bevacizumab (Avastin) patient drug information (UpToDate)]</ref>
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===[[Breast cancer]] - '''WITHDRAWN'''===
 
===[[Breast cancer]] - '''WITHDRAWN'''===
 
*2008-02-22: Granted accelerated approval for use in combination with [[Paclitaxel (Taxol)|paclitaxel]] for the treatment of patients who have not received chemotherapy for metastatic [[Breast_cancer|HER2 negative breast cancer]]. ''(New disease entity; based on ECOG E2100)''
 
*2008-02-22: Granted accelerated approval for use in combination with [[Paclitaxel (Taxol)|paclitaxel]] for the treatment of patients who have not received chemotherapy for metastatic [[Breast_cancer|HER2 negative breast cancer]]. ''(New disease entity; based on ECOG E2100)''
**2011-11-18: Approval for metastatic [[Breast_cancer|HER2 negative breast cancer]] withdrawn. ''(Based on AVADO & RIBBON-1)''
+
**2011-11-18: Accelerated approval for metastatic [[Breast_cancer|HER2 negative breast cancer]] withdrawn. ''(Based on AVADO & RIBBON-1)''
 
***Note: this withdrawal is considered to be controversial, and the breast cancer indication remains in the EMA approval. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744967/ This article] provides a good overview.
 
***Note: this withdrawal is considered to be controversial, and the breast cancer indication remains in the EMA approval. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744967/ This article] provides a good overview.
  
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===[[Colorectal cancer]]===
 
===[[Colorectal cancer]]===
*'''2004-02-26: [http://www.accessdata.fda.gov/drugsatfda_docs/appletter/2004/125085ltr.pdf Initial FDA approval]''', in combination with intravenous [[Regimen_classes#5-FU-based_regimen|5-fluorouracil–based chemotherapy]]...for first- line treatment of patients with metastatic carcinoma of the [[Colon_cancer|colon]] or [[Rectal_cancer|rectum]]. ''(Based on AVF2107g)''
+
*'''2004-02-26: [http://www.accessdata.fda.gov/drugsatfda_docs/appletter/2004/125085ltr.pdf Initial FDA approval]''', in combination with intravenous [[Regimen_classes#5-FU-based_regimen|5-fluorouracil-based chemotherapy]]...for first- line treatment of patients with metastatic carcinoma of the [[Colon_cancer|colon]] or [[Rectal_cancer|rectum]]. ''(Based on AVF2107g)''
 
*2006-06-20: Approved for second-line treatment of metastatic carcinoma of the [[Colon_cancer|colon]] or [[Rectal_cancer|rectum]]. ''(New treatment setting without explicit requirement for combination therapy; based on ECOG E3200 & TRC-301)''
 
*2006-06-20: Approved for second-line treatment of metastatic carcinoma of the [[Colon_cancer|colon]] or [[Rectal_cancer|rectum]]. ''(New treatment setting without explicit requirement for combination therapy; based on ECOG E3200 & TRC-301)''
 
*2013-01-23: Approved for use in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy for the treatment of patients with metastatic [[colorectal cancer]] (mCRC) whose disease has progressed on a first-line [[Regimen_classes#Bevacizumab-containing_regimen|bevacizumab-containing regimen]]. ''(Based on ML18147)''
 
*2013-01-23: Approved for use in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy for the treatment of patients with metastatic [[colorectal cancer]] (mCRC) whose disease has progressed on a first-line [[Regimen_classes#Bevacizumab-containing_regimen|bevacizumab-containing regimen]]. ''(Based on ML18147)''
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==History of changes in EMA indication==
 
==History of changes in EMA indication==
*2005-01-12: Initial market authorization as Avastin.
+
*2005-01-12: Initial market authorization as Avastin in combination with intravenous 5-fluorouracil/folinic acid or intravenous 5-fluorouracil/folinic acid/irinotecan for first-line treatment of patients with metastatic carcinoma of the colon or rectum. ''(Based on AVF2107g & AVF0780g)''
 +
*2011-12-19: Extension of indication to include the use of Avastin, in combination with carboplatin and paclitaxel for the front-line treatment of advanced (FIGO staqes III B, III C and IV) [[Ovarian cancer|epithelial ovarian, fallopian tube, or primary peritoneal cancer]].
 +
*2014-07-31: Extension of indication to include Avastin in combination with paclitaxel, topotecan, or peqylated liposomal doxorubicin for the treatment of adult patients with platinum-resistant recurrent [[Ovarian cancer|epithelial ovarian, fallopian tube, or primary peritoneal cancer]] who received no more than two prior chemotherapy regimens and who have not received prior therapy with bevacizumab or other VEGF inhibitors or VEGF receptor-tarqeted aqents.
 +
*2015-03-30: Extension of Indication to include treatment of adult patients with persistent, recurrent, or metastatic [[Cervical cancer|carcinoma of the cervix]] for Bevacizumab in combination with paclitaxel and cisplatin or paclitaxel and topotecan.
 +
*2016-06-02: Extension of indication to include the combination of bevacizumab with erlotinib for the first line treatment of patients with unresectable advanced, metastatic or recurrent [[Non-small cell lung cancer, nonsquamous|non-squamous non-small cell lung cancer (NSCLC)]] with Epidermal Growth Factor Receptor (EGFR) activatinq mutations.
 +
*2017-06-02: Extension of indication to include the use of Avastin in combination with paclitaxel and carboplatin for the for treatment of adult patients with first recurrence of platinum-sensitive [[Ovarian cancer|epithelial ovarian, fallopian tube or primary peritoneal cancer]] who have not received prior therapy with bevacizumab or other VEGF inhibitors or VEGF receptor-tarqeted aqents.
 +
 
 
==History of changes in Health Canada indication==
 
==History of changes in Health Canada indication==
 +
*2005-09-09: Initial notice of compliance.
 
*2011-11-25: Avastin used in combination with paclitaxel is indicated for the treatment of patients with metastatic HER2-negative [[breast cancer]] and who are ECOG Class 0-1, has been suspended.
 
*2011-11-25: Avastin used in combination with paclitaxel is indicated for the treatment of patients with metastatic HER2-negative [[breast cancer]] and who are ECOG Class 0-1, has been suspended.
 
*2018-05-23: Avastin, as a single agent, for the treatment of patients with [[Glioblastoma|glioblastoma (GBM)]] after relapse or disease progression, following prior therapy, has been withdrawn.
 
*2018-05-23: Avastin, as a single agent, for the treatment of patients with [[Glioblastoma|glioblastoma (GBM)]] after relapse or disease progression, following prior therapy, has been withdrawn.
 +
 
==History of changes in PMDA indication==
 
==History of changes in PMDA indication==
*2020-09-25: new indication and a new dosage for the treatment of unresectable [[hepatocellular carcinoma]].
+
*2007-04-18: Initial approval for the treatment of unresectable advanced/relapsed [[colorectal cancer]].
 +
*2009-09-18: New additional indication for combination therapy with other anticancer drugs (XELOX + BV regimen) for advanced or recurrent [[colorectal cancer]] not suited for curative resection.
 +
*2009-11-06: New additional indication and a new dosage for the treatment of unresectable advanced or recurrent [[Non-small cell lung cancer, nonsquamous|non-squamous non-small cell lung cancer]].
 +
*2011-09-26: New additional indication and a new dosage for the treatment of unresectable or recurrent [[breast cancer]].
 +
*2013-06-14: New additional indication and a new dosage for the treatment of [[:Category:High-grade gliomas|malignant glioma]].
 +
*2013-11-22: New additional indication for the treatment of [[ovarian cancer]].
 +
*2016-05-23: New additional indication for the treatment of advanced or recurrent [[cervical cancer]].
 +
*2020-09-25: New indication and a new dosage for the treatment of unresectable [[hepatocellular carcinoma]].
 +
 
 
==Also known as==
 
==Also known as==
 
*'''Generic name:''' rhuMab-VEGF
 
*'''Generic name:''' rhuMab-VEGF
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[[Category:Carcinoma of unknown primary medications]]
 
[[Category:Carcinoma of unknown primary medications]]
 
[[Category:Anaplastic glioma medications]]
 
[[Category:Anaplastic glioma medications]]
[[Category:Bladder cancer medications]]
+
[[Category:Angiosarcoma medications]]
 
[[Category:Breast cancer medications]]
 
[[Category:Breast cancer medications]]
 
[[Category:Cervical cancer medications]]
 
[[Category:Cervical cancer medications]]
 
[[Category:Cholangiocarcinoma medications]]
 
[[Category:Cholangiocarcinoma medications]]
 
[[Category:Colorectal cancer medications]]
 
[[Category:Colorectal cancer medications]]
 +
[[Category:Endometrial cancer medications]]
 
[[Category:Esophageal cancer medications]]
 
[[Category:Esophageal cancer medications]]
 
[[Category:Follicular lymphoma medications]]
 
[[Category:Follicular lymphoma medications]]
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[[Category:Small cell lung cancer medications]]
 
[[Category:Small cell lung cancer medications]]
 
[[Category:Testicular cancer medications]]
 
[[Category:Testicular cancer medications]]
[[Category:Endometrial cancer medications]]
+
[[Category:Urothelial carcinoma medications]]
[[Category:Angiosarcoma medications]]
 
  
 
[[Category:EMA approved in 2005]]
 
[[Category:EMA approved in 2005]]
 
[[Category:FDA approved in 2004]]
 
[[Category:FDA approved in 2004]]
[[Category:PMDA approved drugs]]
+
[[Category:Health Canada approved in 2005]]
 +
[[Category:PMDA approved in 2007]]

Revision as of 11:18, 9 April 2024

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 established (work in progress)

Diseases for which it is used

Information about counterfeit bevacizumab

Patient drug information

History of changes in FDA indication

Breast cancer - WITHDRAWN

  • 2008-02-22: 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; based on ECOG E2100)
    • 2011-11-18: Accelerated approval for metastatic HER2 negative breast cancer withdrawn. (Based on AVADO & RIBBON-1)
      • Note: this withdrawal is considered to be controversial, and the breast cancer indication remains in the EMA approval. This article provides a good overview.

Cervical cancer

Colorectal cancer

  • 2004-02-26: 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. (Based on AVF2107g)
  • 2006-06-20: Approved for second-line treatment of metastatic carcinoma of the colon or rectum. (New treatment setting without explicit requirement for combination therapy; based on ECOG E3200 & TRC-301)
  • 2013-01-23: Approved for use in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy for the treatment of patients with metastatic colorectal cancer (mCRC) whose disease has progressed on a first-line bevacizumab-containing regimen. (Based on ML18147)
  • Metastatic colorectal cancer, with intravenous 5-fluorouracil–based chemotherapy for first- or second-line treatment.
  • Limitation: Lack of efficacy in adjuvant treatment of colon cancer. (Based on AVANT & NSABP C-08)

Glioblastoma

  • 2009-05-05: Granted accelerated approval as a single agent for patients with glioblastoma, with progressive disease following prior therapy. (Based on NCI 06-C-0064E & AVF3708g)
    • 2017-12-05: Converted to regular approval for patients with glioblastoma with progressive disease following prior therapy. (Based on EORTC 26101)

Hepatocellular carcinoma

  • 2020-05-29: Approved in combination with atezolizumab for patients with unresectable or metastatic hepatocellular carcinoma who have not received prior systemic therapy. (Based on IMbrave150)

Non-small cell lung cancer, nonsquamous

Ovarian cancer

Renal cell carcinoma

  • 2009-07-31: Approved in combination with interferon alfa for the treatment of patients with metastatic renal cell carcinoma. (Based on AVOREN)

History of changes in EMA indication

  • 2005-01-12: Initial market authorization as Avastin in combination with intravenous 5-fluorouracil/folinic acid or intravenous 5-fluorouracil/folinic acid/irinotecan for first-line treatment of patients with metastatic carcinoma of the colon or rectum. (Based on AVF2107g & AVF0780g)
  • 2011-12-19: Extension of indication to include the use of Avastin, in combination with carboplatin and paclitaxel for the front-line treatment of advanced (FIGO staqes III B, III C and IV) epithelial ovarian, fallopian tube, or primary peritoneal cancer.
  • 2014-07-31: Extension of indication to include Avastin in combination with paclitaxel, topotecan, or peqylated liposomal doxorubicin for the treatment of adult patients with platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who received no more than two prior chemotherapy regimens and who have not received prior therapy with bevacizumab or other VEGF inhibitors or VEGF receptor-tarqeted aqents.
  • 2015-03-30: Extension of Indication to include treatment of adult patients with persistent, recurrent, or metastatic carcinoma of the cervix for Bevacizumab in combination with paclitaxel and cisplatin or paclitaxel and topotecan.
  • 2016-06-02: Extension of indication to include the combination of bevacizumab with erlotinib for the first line treatment of patients with unresectable advanced, metastatic or recurrent non-squamous non-small cell lung cancer (NSCLC) with Epidermal Growth Factor Receptor (EGFR) activatinq mutations.
  • 2017-06-02: Extension of indication to include the use of Avastin in combination with paclitaxel and carboplatin for the for treatment of adult patients with first recurrence of platinum-sensitive epithelial ovarian, fallopian tube or primary peritoneal cancer who have not received prior therapy with bevacizumab or other VEGF inhibitors or VEGF receptor-tarqeted aqents.

History of changes in Health Canada indication

  • 2005-09-09: Initial notice of compliance.
  • 2011-11-25: Avastin used in combination with paclitaxel is indicated for the treatment of patients with metastatic HER2-negative breast cancer and who are ECOG Class 0-1, has been suspended.
  • 2018-05-23: Avastin, as a single agent, for the treatment of patients with glioblastoma (GBM) after relapse or disease progression, following prior therapy, has been withdrawn.

History of changes in PMDA indication

  • 2007-04-18: Initial approval for the treatment of unresectable advanced/relapsed colorectal cancer.
  • 2009-09-18: New additional indication for combination therapy with other anticancer drugs (XELOX + BV regimen) for advanced or recurrent colorectal cancer not suited for curative resection.
  • 2009-11-06: New additional indication and a new dosage for the treatment of unresectable advanced or recurrent non-squamous non-small cell lung cancer.
  • 2011-09-26: New additional indication and a new dosage for the treatment of unresectable or recurrent breast cancer.
  • 2013-06-14: New additional indication and a new dosage for the treatment of malignant glioma.
  • 2013-11-22: New additional indication for the treatment of ovarian cancer.
  • 2016-05-23: New additional indication for the treatment of advanced or recurrent cervical cancer.
  • 2020-09-25: New indication and a new dosage for the treatment of unresectable hepatocellular carcinoma.

Also known as

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

References