Avastin Drug Description:
Avastin (bevacizumab) is a synthetic antibody that is used in combination with chemotherapy to treat several types of cancer, including metastatic colorectal, advanced nonsquamous non-small cell lung, adult glioblastoma, and metastatic kidney cancers. It may sometimes be given off-label for metastatic breast cancer. Avastin targets a protein called vascular endothelial growth factor (VEGF).
Drug Interactions: No formal studies of drug interactions with Avastin have been done, so it is not yet known if Avastin will interact badly with other medications.
Avastin For Metastatic Breast Cancer:
Avastin was previously approved by the FDA for use in combination with Taxol (paclitaxel) to treat metastatic breast cancer. One study showed that Avastin might have helped patients live longer without having their disease get worse by slowing or stopping tumor growth. Some patients in this study gained 6 to 11 months of progression-free survival time with Avastin. Avastin got FDA approval for use with breast cancer in 2008, but by December 2010 the agency prepared to revoke its approval because follow-up studies failed to show greater improvements than anticipated. The drug's maker Genentech appealed, but the data supporting Avastin did not live up to expectations. In November 2011 the drug was withdrawn from use for breast cancer, except for off-label use or as part of clinical trials. Many health insurance providers may not cover off-label drugs, however, oncology medical societies may still support its use in breast cancer.
How Avastin Works:
A tumor needs nutrients and oxygen from blood in order to grow and spread. It can hijack your circulation in order to get its blood supply. During tumor angiogenesis, a tumor can secrete VEGF protein to stimulate the growth of new blood vessels, which will grow into, and nourish the tumor. Avastin seeks out VEGF proteins and binds to them, preventing the stimulation of new blood vessels, cutting off circulation to tumors. Without tumor angiogenesis, a tumor may grow more slowly, or stop growing altogether.
How Avastin Is Given:
Avastin is a clear liquid, usually colorless, but sometimes pale brown. This drug is given with a chemotherapy infusion (IV) every 14 days.
Some Common Side Effects of Avastin:
- High blood pressure
- Fatigue
- Mouth sores (mucositis)
- Blood clots (higher risk in elderly patients)
- Diarrhea
- Low white cell counts
- Headache
- Appetite loss
Serious Side Effects:
- Perforation of the colon, requiring surgical repair
- Difficulty healing from wounds
- Bleeding that results in stroke or possibly death
- Heart failure (in patients taking other cancer drugs which weaken the heart)
- Kidney damage
Call Your Doctor if You Have These Symptoms:
- Trouble with breathing
- Abdominal pain
- Constipation
- Vomiting
- Uncontrolled bleeding
Who Should Not Take Avastin:
If you have had surgery in the previous 28 days, you should not take Avastin. Since this drug can disrupt wound healing, all incisions must be completely healed before treatment can safely begin. Patients who have breast cancer that has spread to the brain should not take Avastin, because of possible uncontrolled bleeding.
Recommendations During Treatment:
- Have your blood pressure checked regularly to guard against high blood pressure
- Have regular complete blood counts performed with special attention to white cell counts
- Check urine for proteinuria (too much protein in your urine)
- Clean and cover any cuts you may have, change dressings regularly
- Do not breastfeed, it is not known how Avastin would affect an infant
- Avoid sharp edges (prevent cuts and bruises)
- Practice contraception, because Avastin can prevent circulatory development in a fetus
Sources:
FDA. Avastin Drug Information. Questions and Answers on Avastin (bevacizumab). Updated: February 26, 2004.
National Cancer Institute. Bevacizumab Drug Information. Updated: 11/18/2011.
