Bevacizumab  

Trade name: Avastin  

Generic name: Bevacizumab 

Therapeutic Class:  monoclonal antibody" and "anti-angiogenesis 

Manufacturer / Distributor:   Roche 

Availability:  Avastin is available by prescription only 

Manufacturer / Distributor:   Roche 

Availability:  Bevacizumab is available by prescription only 

Indications: Bevacizumab is used to treat the following cancers:  

Metastatic colorectal cancer – in the treatment of metastatic colorectal cancer, Bevacizumab is usually given at the following doses: 5 mg/kg or 10 mg/kg body weight, administered once every 2 weeks; 7.5 mg/kg or 15 mg/kg administered once every 3 weeks through intravenous infusion.  

Metastatic breast cancer – to treat metastatic breast cancer, Bevacizumab is recommended at 10 mg / kg of body weight, administered once every 2 weeks; or the dosage of 15 mg/kg body weight once every 3 weeks, given by infusion into a vein . 

Non-small cell Lung cancer (NSCLC) – in the treatment of NSCLC, Bevacizumab is given in combination with a p latinum- based chemotherapy up to 6 cycles of treatment, followed by an Bevacizumab monochemotherapy ( Bevacizumab only) until remission. The recommendation is 7.5 mg/kg or 15 mg/kg body weight given once every 3 weeks by intravenous infusion. 

Advanced or metastatic kidney cancer – if you have an advanced kidney cancer, the dosage of Bevacizumab that your doctor can recommend is 10 mg/kg of body weight, given once every 2 weeks by intravenous infusion. 

Bevacizumab can be used to treat age-related macular degeneration and other forms of cancers such as: 

• ovarian cancer
• prostate cancer
• non-metastatic unresectable liver cancer
• metastatic or unresectable locally advanced pancreatic cancer
• Glioblastoma multiforme (GBM), an aggressive form of primary brain tumor.

Dosage form: Bevacizumab is given by infusion into a vein (intravenous, IV)  

Dosage:  Bevacizumab should be administered by professionals with the greatest care possible. It is recommended that the drug be given in hospital or health care center equipped for its preparation. Bevacizumab is given by intravenous infusion every 14 days. In general, the first dose is administered by intravenous infusion over 90 minutes. Depending on the reaction of your body to the drug, the second infusion will last 60 minutes. If the second infusion is well tolerated by your body, all subsequent infusions may be administered in 30 minutes.  

If your body's reaction to the medication is not life threatening, dosage reduction is not recommended; the drug must be taken as indicated. If life threatening reactions develop however, the treatment should be stopped permanently or temporarily.  

Overdose: the highest dose ever given to humans is 20 mg / kg of body weight every 2 weeks. In the majority of patients, however, Bevacizumab overdose causes severe migraine and other health problems. If you experience symptoms related to overdose during the treatment, call your doctor or pharmacist right away.  

Missing dose: if there are no major complications, treatment should not be interrupted. If for some reasons you will not be present for the treatment, talk to your doctor in advance so that he can do the necessary. Misusing chemotherapy drugs, including Bevacizumab, can be nefast.  

Contraindication/Precaution – Bevacizumab is not recommended or should be used with precaution in the following circumstances: 

• women who are pregnant or nursing  
• seniors  
• children and adolescents  
• chronic renal failure 
• chronic hepatic disease (liver disease) 
• allergic to Bevacizumab or any of its  ingredients  
• allergy to products derived from chinese hamster ovary (CHO) cells or humanized antibodies 
• Untreated cancer that has spread into the central nervous system.  

Mechanism of Action (MOA): Bevacizumab is an antineoplastic agent that works by preventing the production of blood vessels that nourish the cancer cells, which may then inhibit the growth of the tumor. 

Interactions:  combination of Bevacizumab with certain drugs can reduce its curative effect, and even cause health problems. Therefore, before beginning the treatment, tell your doctor about prescription or/and nonprescription medications you are taking. It is important to have the advice of your doctor before taking vitamins, nutritional supplements and over-the-counter drugs.   

Side effects: Bevacizumab can bring good results in some cancer patients; however, it tends to cause adverse effects, which can be serious. The most common Bevacizumab  side effects include:   

• redness, itching, or scaling of the skin
• dizziness
• fatigue
• bleeding nose
• bleeding gums
• taste Changes
• dry mouth
• decreased appetite
• heartburn
• diarrhea
• weight loss
• Sores on the skin or in the mouth.

Bevacizumab can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:  

• fainting
• seizures
• chest/neck pain
• shortness of breath
• loss of vision
• vomiting Blood
• black or bloody stools
• dry, hacking cough
• severe vaginal bleeding
• slow or difficult speech
• weakness or numbness of an arm or leg
• dizziness, faintness or confusion
• coughing, gagging, or choking
• Severe headache (which can be a sign of overdose)
• Pain or swelling of the face, eyes, stomach, hands, feet, ankles, or lower legs.