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Bevacizumab
Bevacizumab is a monoclonal antibody used as an anti-angiogenic treatment for various types of cancer. It is designed to inhibit vascular endothelial growth factor (VEGF), a protein that stimulates the formation of blood vessels. By blocking VEGF, Bevacizumab prevents the growth of new blood vessels that supply tumors with oxygen and nutrients, thereby slowing the growth and spread of cancer. Bevacizumab is commonly used in combination with chemotherapy to treat cancers such as colorectal cancer, lung cancer, glioblastoma, and renal cell carcinoma.
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Frequently Asked Questions
How long does it take for Bevacizumab to start working?
The time it takes for Bevacizumab to show effects varies depending on the type of cancer and the individual’s response. In some cases, tumor shrinkage or a reduction in symptoms may be observed after a few cycles of treatment. Regular imaging studies are used to assess the effectiveness of the therapy.
Can I stop taking Bevacizumab if my symptoms improve?
No, you should not stop taking Bevacizumab without consulting your healthcare provider. The decision to stop treatment is based on a comprehensive evaluation of your condition, including imaging results and overall health.
Is Bevacizumab safe to use during pregnancy?
Bevacizumab is not recommended during pregnancy, as it can cause harm to the developing fetus. Women of childbearing age should use effective contraception during treatment and for at least 6 months after the last dose. If pregnancy occurs, inform your healthcare provider immediately.
What should I do if I miss a dose of Bevacizumab?
If you miss a scheduled dose of Bevacizumab, contact your healthcare provider for advice. Do not try to make up for the missed dose on your own.
Can Bevacizumab cause hair loss?
Hair loss is not a common side effect of Bevacizumab itself, but it may occur if Bevacizumab is used in combination with certain chemotherapy drugs that are known to cause hair loss. Discuss any concerns with your healthcare provider.
Can I take Bevacizumab if I'm allergic to chemotherapy medication?
If you've ever had a serious allergic reaction to chemotherapy medications or an allergic reaction specifically to Bevacizumab, it's crucial to inform your doctor before initiating the treatment.
Comprehensive Drug Guide
How Does Bevacizumab Work?
Bevacizumab works by binding to VEGF, a key protein responsible for angiogenesis (the formation of new blood vessels). By inhibiting VEGF, Bevacizumab prevents the growth of blood vessels that tumors need to grow and spread. This action starves the tumor of nutrients and oxygen, which can slow its growth and reduce the size of the tumor. In combination with chemotherapy, Bevacizumab enhances the overall effectiveness of cancer treatment.
What is Bevacizumab Used For?
Metastatic Colorectal Cancer: In combination with intravenous fluorouracil-based chemotherapy as first- or second-line treatment.
Non-Small Cell Lung Cancer (NSCLC): In combination with carboplatin and paclitaxel for first-line treatment of unresectable, locally advanced, recurrent, or metastatic non-squamous NSCLC.
Glioblastoma: As a single agent for patients with progressive glioblastoma following prior therapy.
Metastatic Renal Cell Carcinoma (RCC): In combination with interferon alfa.
Cervical Cancer: In combination with paclitaxel and cisplatin, or paclitaxel and topotecan for persistent, recurrent, or metastatic cervical cancer.
Ovarian Cancer: For recurrent, platinum-resistant, or platinum-sensitive ovarian cancer in combination with chemotherapy.
Common Dosages
- Administration: Bevacizumab is administered by intravenous infusion. The initial dose is typically given over 90 minutes. If tolerated, subsequent doses can be administered over 60 minutes or 30 minutes. The frequency of administration depends on the specific type of cancer being treated and the patient’s response to therapy.
- Monitoring: Patients receiving Bevacizumab should be monitored regularly for blood pressure, signs of bleeding, and proteinuria (protein in the urine). Imaging studies are also used to assess the effectiveness of treatment.
Typical Dosing
FDA Approved Indications
- Metastatic Colorectal Cancer: 5 mg/kg or 10 mg/kg every 2 weeks, depending on the chemotherapy regimen.
- Non-Small Cell Lung Cancer: 15 mg/kg every 3 weeks in combination with carboplatin and paclitaxel.
- Glioblastoma: 10 mg/kg every 2 weeks as a single agent.
- Metastatic Renal Cell Carcinoma: 10 mg/kg every 2 weeks in combination with interferon alfa.
- Cervical Cancer: 15 mg/kg every 3 weeks in combination with chemotherapy.
- Ovarian Cancer: 15 mg/kg every 3 weeks in combination with chemotherapy, or as per specific treatment protocols.
Who Shouldn't Take Bevacizumab?
- Known hypersensitivity to Bevacizumab or any component of the formulation.
- Recent history of significant bleeding or hemorrhage.
- Recent surgery or significant wounds that have not healed, as Bevacizumab can impair wound healing.
- Untreated central nervous system (CNS) metastases, due to the risk of CNS bleeding.
Advice From The Pharmacist
- Report any unusual symptoms, such as severe headaches, dizziness, chest pain, or signs of bleeding (e.g., nosebleeds, coughing up blood), to their healthcare provider immediately.
- Be aware of the increased risk of high blood pressure (hypertension) and monitor their blood pressure regularly during treatment.
- Avoid elective surgery or dental procedures without consulting their healthcare provider, as Bevacizumab can impair wound healing.
- Inform their healthcare provider if they are pregnant or planning to become pregnant, as Bevacizumab can cause harm to the fetus.
- Attend all scheduled follow-up appointments and imaging studies to monitor the effectiveness and safety of the treatment.
Side Effects of Bevacizumab
Common Side Effects
- High blood pressure (hypertension)
- Fatigue or weakness
- Diarrhea
- Abdominal pain
- Nausea and vomiting
- Loss of appetite
- Mouth sores
Uncommon/Severe Side Effects
- Bleeding: Including gastrointestinal bleeding, nosebleeds, or hemorrhage in the brain.
- Blood Clots: Such as deep vein thrombosis (DVT), pulmonary embolism, or stroke.
- Gastrointestinal Perforation: A rare but serious complication involving a hole in the stomach or intestines.
- Wound Healing Complications: Delayed healing or wound dehiscence (reopening of a surgical wound).
- Nephrotic Syndrome: A kidney condition leading to proteinuria and swelling.
- Infusion Reactions: Including fever, chills, and difficulty breathing during the infusion.
Risks and Warnings of Bevacizumab
- Bleeding Risk: Bevacizumab increases the risk of bleeding, including serious and potentially fatal hemorrhages. Patients with a history of bleeding disorders or those receiving anticoagulant therapy should be closely monitored.
- Hypertension: Bevacizumab can cause significant increases in blood pressure. Patients should have their blood pressure monitored regularly, and antihypertensive treatment may be required.
- Gastrointestinal Perforation: Although rare, Bevacizumab can cause gastrointestinal perforation, which is a life-threatening condition requiring immediate medical attention.
- Impaired Wound Healing: Bevacizumab can impair wound healing, so it should be discontinued before elective surgery and not resumed until wounds have healed.
- Proteinuria: Bevacizumab can cause proteinuria, which may indicate kidney damage. Regular urine tests are recommended during treatment.
Interactions with Bevacizumab
Common Drug Interactions
- Anticoagulants: Such as warfarin or heparin, which can increase the risk of bleeding when used with Bevacizumab.
- Antihypertensives: May be needed to manage the increased blood pressure associated with Bevacizumab.
- Other Anti-Angiogenic Agents: Concurrent use with other VEGF inhibitors may increase the risk of adverse effects such as bleeding or hypertension.
Alternatives to Bevacizumab
- Other Anti-Angiogenic Agents: Such as ramucirumab (Cyramza), which also targets VEGF and is used in similar types of cancer.
- Targeted Therapies: Such as cetuximab (Erbitux) for colorectal cancer, or pembrolizumab (Keytruda) for non-small cell lung cancer, depending on the specific cancer type and genetic markers.
- Chemotherapy: Different chemotherapy regimens depending on the type and stage of cancer.
- Radiation Therapy: In some cases, radiation may be used in conjunction with or instead of targeted therapies.
The choice of treatment depends on the specific type of cancer, its stage, and the patient’s overall health and response to previous treatments.
