From the Guidelines
Bevacizumab is indicated for the treatment of metastatic colorectal cancer, and its use has been shown to improve survival and progression-free survival in combination with chemotherapy regimens such as FOLFIRI and FOLFOX 1. The most recent and highest quality study, published in 2024, found that the continuation of bevacizumab after progression on bevacizumab was associated with a longer overall survival and a longer post-progression overall survival in patients with metastatic colorectal cancer 1. Some key points to consider when using bevacizumab include:
- Bevacizumab is typically administered intravenously every 2-3 weeks, with dosing ranging from 5-15 mg/kg depending on the cancer type.
- Common side effects include hypertension, proteinuria, impaired wound healing, and in rare cases, serious adverse events like gastrointestinal perforation, hemorrhage, or arterial thromboembolic events.
- Patients should have their blood pressure monitored regularly during treatment, and bevacizumab should be discontinued at least 6 weeks before elective surgery due to its effects on wound healing 1. It is also important to note that bevacizumab may interfere with wound healing, and its use has been associated with a higher incidence of treatment-related mortality than chemotherapy alone 1. Overall, the use of bevacizumab in the treatment of metastatic colorectal cancer has been shown to be effective in improving survival and progression-free survival, but its use should be carefully considered and monitored due to its potential side effects.
From the FDA Drug Label
Avzivi is a vascular endothelial growth factor inhibitor indicated for the treatment of: Metastatic colorectal cancer, in combination with intravenous fluorouracilbased chemotherapy for first- or second-line treatment. Metastatic colorectal cancer, in combination with fluoropyrimidine irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy for second-line treatment in patients who have progressed on a first-line bevacizumab product-containing regimen. Unresectable, locally advanced, recurrent or metastatic non-squamous non-small cell lung cancer, in combination with carboplatin and paclitaxel for first-line treatment. Recurrent glioblastoma in adults. Metastatic renal cell carcinoma in combination with interferon alfa. Persistent, recurrent, or metastatic cervical cancer, in combination with paclitaxel and cisplatin, or paclitaxel and topotecan. Epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for platinum-resistant recurrent disease who received no more than 2 prior chemotherapy regimens.
The indication for Bevacizumab is for the treatment of various types of cancer, including:
- Metastatic colorectal cancer
- Non-squamous non-small cell lung cancer
- Recurrent glioblastoma
- Metastatic renal cell carcinoma
- Persistent, recurrent, or metastatic cervical cancer
- Epithelial ovarian, fallopian tube, or primary peritoneal cancer 2
From the Research
Bevacizumab Indication
- Bevacizumab is indicated for the treatment of metastatic colorectal cancer 3, 4, 5, 6.
- It is used in combination with chemotherapy, such as irinotecan, 5-fluorouracil, and leucovorin, to improve survival and response rates in patients with metastatic colorectal cancer 3, 4, 5, 6.
- Bevacizumab has also been shown to be effective in combination with other chemotherapy regimens, such as oxaliplatin-containing and 5-fluorouracil-based regimens 3, 6.
- The addition of bevacizumab to chemotherapy has been shown to confer a clinically meaningful and statistically significant improvement in overall survival, progression-free survival, and overall response rate in patients with metastatic colorectal cancer 6.
Side Effects and Monitoring
- Bevacizumab is generally well tolerated, but it can cause side effects such as hypertension, proteinuria, bleeding, gastrointestinal perforation, and arterial thrombotic events 3, 4, 5, 6.
- Patients receiving bevacizumab should be monitored closely for these side effects, especially those who are at greater risk of adverse events 3, 4, 6.
- Bevacizumab has also been associated with a skin rash in some patients, which may be correlated with a positive response to therapy 7.