Bevacizumab

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Adverse-effects 4 Drug-interactions 5 Mechanism-of-action 6 More General Terms 7 References

Introduction

• Tradename: Avastin ( FDA approved 2004), Altuzan not approved by FDA for use in the United States (it is an approved drug in Turkey) [15]

Indications

• metastatic colorectal cancer

• in combination with conventional chemotherapy
• improves survival by about 5 months) [2]

• metastatic renal cell carcinoma, in combination with interferon alpha-2a (investigational) [12]
• treatment of exudative macular degeneration Contraindicatons:

• in combination with paclitaxel for treatment of metastatic breast cancer [11]; FDA approval revoked Nov 2011 [14]; not safe & effective for this indication

Adverse-effects

• infusion reaction [13]
• hypertension
• hemoptysis
• gastrointestinal bleeding
• thrombosis
• increase in treatment-related mortality
• reversible posterior leukoencephalopathy syndrome [7]
• nasal septum perforation
• tracheo- esophageal (TE) fistula in contex of persistent esophagitis [8]

Drug-interactions

• several reports of microangiopathic hemolytic anemia in patients with solid tumors receiving Avastin in combination with sunitinib malate; this combination is not recommended [9]

Mechanism-of-action

• angiogenesis inhibitor, binds to VEGF
• reduces blood supply to tumors

More General Terms

• antineoplastic agent (chemotherapeutic agent)

References

1. Prescriber's Letter 10(6):35 2003
2. Prescriber's Letter 11(3):16 2004 Detail-Document#: [1] (subscription needed) [2]
3. Genentech, Inc. 1 DNA Way South San Francisco, California 94080-4990 USA Phone: 650-225-1000 Fax: 650-225-6000 [3]
4. Bevacizumab (Avastin) for Metastatic Colorectal Cancer [4]
5. Journal Watch 25(14):112, 2005
6. Grand Rounds UC Davis
7. FDA Medwatch [5]
8. FDA Medwatch [6]
9. FDA Medwatch [7]
10. PubMed Search PubMed search: [la&tool=anvita&email=s.ball@anvita.info]
11. Miller K et al. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med 2007 Dec 27; 357:2666. PMID: &dopt=Abstract
    - FDA advisory committee does not recommend approval for Avastin® for breast cancer. [8]
    - Miller R. The biotech bottleneck. Wall Street Journal Dec 28 , 2007:A13 [9]
    - FDA MedWatch Avastin (bevacizumab): Process for Removal of Breast Cancer Indication Begun [10]
12. Escudier BJ et al Final results of the phase III, randomized, double-blind AVOREN trial of first-line bevacizumab (BEV) + interferon-alpha 2a (IFN) in metastatic renal cell carcinoma (mRCC). J Clin Oncol 27:15s, 2009 (suppl; abstr 5020) [11]
13. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
14. MedScape Oncology, Nov 18, 2011 FDA MedWatch Pending
15. FDA MedWatch Altuzan (bevacizumab): Counterfeit Product - Contains no Active Ingredient [12]

bevacizumab (Avastin, Altuzan)