Bevacizumab (Avastin)
Jump to navigation
Jump to search
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)
- Cervical cancer
- Colorectal cancer
- Glioblastoma
- Hepatocellular carcinoma
- Malignant pleural mesothelioma
- Non-small cell lung cancer, nonsquamous
- Ovarian cancer
- Renal cell carcinoma
Diseases for which it is used
- Carcinoma of unknown primary
- Anaplastic glioma
- Angiosarcoma
- Bladder cancer
- Breast cancer
- Cholangiocarcinoma
- Esophageal cancer
- Follicular lymphoma
- Gallbladder cancer
- Gastric cancer
- Kaposi sarcoma
- Malignant peritoneal mesothelioma
- Melanoma
- Neuroendocrine tumor
- Non-small cell lung cancer
- Pancreatic NET
- Small cell lung cancer
- Testicular cancer
- Endometrial cancer
Information about counterfeit bevacizumab
- FDA's 2012-02-14 statement about counterfeit Avastin in U.S.
- Genentech's 2012-02-14 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Breast cancer - WITHDRAWN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- 2011-11-18: Approval for metastatic HER2 negative breast cancer withdrawn.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.
- 2011-11-18: Approval for metastatic HER2 negative breast cancer withdrawn. (Based on AVADO & RIBBON-1)
Cervical cancer
- 2014-08-14: Approved for treatment of cervical cancer, in combination with paclitaxel and cisplatin or paclitaxel and topotecan in persistent, recurrent, or metastatic disease. (Based on GOG 240)
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
- 2006-10-11: Approved for non-squamous, non-small cell lung cancer, with carboplatin and paclitaxel for first line treatment of unresectable, locally advanced, recurrent or metastatic disease. (New disease entity; based on ECOG E4599 & AVAil)
Ovarian cancer
- 2014-11-14: Approved for treatment of platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer, in combination with paclitaxel, pegylated liposomal doxorubicin or topotecan. (Based on AURELIA)
- 2016-12-06: Approved for recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer that is platinum-sensitive in combination with carboplatin and paclitaxel or in combination with carboplatin and gemcitabine, followed by Avastin as a single agent. (Based on NRG/GOG-0213 and OCEANS)
- 2018-06-13: 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; based on GOG-0218)
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.
History of changes in Health Canada indication
- 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
- 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
Categories:
- Drugs
- Intravenous medications
- Neutral
- Anti-VEGF antibodies
- Carcinoma of unknown primary medications
- Anaplastic glioma medications
- Bladder cancer medications
- Breast cancer medications
- Cervical cancer medications
- Cholangiocarcinoma medications
- Colorectal cancer medications
- Esophageal cancer medications
- Follicular lymphoma medications
- Gallbladder cancer medications
- Gastric cancer medications
- Glioblastoma medications
- Hepatocellular carcinoma medications
- Kaposi sarcoma medications
- Malignant peritoneal mesothelioma medications
- Malignant pleural mesothelioma medications
- Melanoma medications
- Neuroendocrine tumor medications
- Non-small cell lung cancer medications
- Non-small cell lung cancer, nonsquamous medications
- Ovarian cancer medications
- Pancreatic NET medications
- Renal cell carcinoma medications
- Small cell lung cancer medications
- Testicular cancer medications
- Endometrial cancer medications
- Angiosarcoma medications
- EMA approved in 2005
- FDA approved in 2004
- PMDA approved drugs