Bevacizumab
Indications
Bevacizumab is a cancer medicine used, usually together with chemotherapy or other cancer medicines, for certain advanced cancers of the bowel (colorectal), lung (non-small cell), kidney, ovary, fallopian tube and peritoneum, cervix, breast and liver, and for a type of brain tumour (glioblastoma). Eye specialists also use it as an injection into the eye for some conditions with leaky blood vessels in the retina, such as wet age-related macular degeneration.
How It Works
It is a monoclonal antibody (a laboratory-made protein) that blocks VEGF, a signal tumours use to grow new blood vessels. Without these vessels the tumour gets less blood and grows more slowly. In the eye it reduces abnormal, leaky blood vessels.
Dosage and Administration
Given only in hospital by a doctor or nurse as a drip into a vein (infusion), usually every 2 or 3 weeks. The dose depends on body weight and the type of cancer, as prescribed by the oncologist. Eye injections are given only by an eye specialist.
Interactions
- With some chemotherapy medicines it can increase the risk of low white blood cell counts and infections.
- With Sunitinib it can cause a serious blood disorder.
- With bisphosphonates such as Zoledronic Acid the risk of jaw bone damage may rise.
Tell your cancer team about every medicine and supplement you take.
Contraindications
Allergy to bevacizumab or to products made from Chinese hamster ovary cells, and pregnancy.
Side Effects
Common: high blood pressure, tiredness, protein in the urine, nosebleeds, mouth sores, diarrhoea, loss of appetite, headache and slow wound healing.
Get urgent medical help for:
- Severe stomach pain, which can mean a tear in the bowel
- Coughing or vomiting blood, black stools or other heavy bleeding
- Chest pain, or weakness of one side, trouble speaking or a drooping face
- Sudden severe headache with confusion, fits or vision loss
- Fever, chills or breathlessness during or after the drip
- A wound that opens up, or fever with signs of infection
Pregnancy and Lactation
It can harm an unborn baby. Women who could become pregnant must use effective contraception during treatment and for 6 months after the last dose. It may affect fertility; discuss this before starting. Do not breastfeed during treatment and for 6 months after the last dose.
Precautions and Warnings
- Treatment is usually stopped at least 28 days before planned surgery and restarted only after the wound has healed.
- Blood pressure and urine are checked regularly.
- Have a dental check before treatment, and tell your dentist you are receiving it.
Overdose
It is given in hospital under close monitoring. Higher than intended doses may cause severe headache; the medical team will manage any problems.
Therapeutic Class
Anticancer monoclonal antibody (VEGF inhibitor).
Storage
Store in a fridge at 2 to 8°C in the original carton to protect from light. Do not freeze or shake. It is stored and prepared by the hospital pharmacy.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Bevacizumab