Difference between revisions of "Bevacizumab (Avastin)"

Revision as of 16:30, 3 February 2020

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)
1/23/2013: 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.
Metastatic colorectal cancer, with intravenous 5-fluorouracil–based chemotherapy for first- or second-line treatment.

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: FDA 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)

Renal cell carcinoma

7/31/2009: Approved in combination with interferon alfa for the treatment of patients with metastatic renal cell carcinoma. (New disease entity)

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 49: / Line 49: @@
 *8/14/2014: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm410128.htm Approved] for treatment of [[Cervical_cancer|cervical cancer]], in combination with [[Paclitaxel (Taxol)|paclitaxel]] and [[Cisplatin (Platinol)|cisplatin]] or [[Paclitaxel (Taxol)|paclitaxel]] and [[Topotecan (Hycamtin)|topotecan]] in persistent, recurrent, or metastatic disease. ''(New disease entity)''
-===Colorectal cancer===
+===[[:Category:Colorectal_cancers|Colorectal cancer]]===
-*'''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]].
+*'''2/26/2004: [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]].
 *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)''
-*1/23/2013: 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.
+*1/23/2013: Approved for use in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy for the treatment of patients with metastatic [[:Category:Colorectal_cancers|colorectal cancer]] (mCRC) whose disease has progressed on a first-line [[Regimen_classes#Bevacizumab-containing_regimen|bevacizumab-containing regimen]].
-*Metastatic [[Colon_cancer|colorectal cancer]], with intravenous [[Fluorouracil (5-FU)|5-fluorouracil]]–based chemotherapy for first- or second-line treatment.
+*Metastatic [[:Category:Colorectal_cancers|colorectal cancer]], with intravenous [[Regimen_classes#5-FU-based_regimen|5-fluorouracil–based chemotherapy]] for first- or second-line treatment.
 ===[[Glioblastoma]]===