Bevacizumab (Avastin)

bevacizumab

The humanized monoclonal antibody bevacizumab, better known by its US trade name Avastin, is the first FDA-approved anti-angiogenesis agent (or angiogenesis inhibitor) in the treatment of cancer. Anti-angiogenesis agents bind to vascular endothelial growth factor (VEGF) in tumors and by doing so it is believed they prevent the tumor from developing the network of blood vessels it needs in order to grow.

What it's effective for and why

The FDA first approved bevacizumab in 2004 as a first-line therapy against metastatic colorectal cancer.

It was the first anti-angiogenesis agent to earn regulatory approval. Anti-angiogenesis agents such as Avastin bind to what is known as vascular endothelial growth factor (VEGF) in tumors. When they do this, it is believed that Avastin prevents the tumor from building blood vessels. Without these blood vessels, the tumor cannot sustain itself.

In subsequent years it was given FDA approval for the following indications:1

  • As second-line treatment of metastatic carcinoma of the colon or rectum (in combination with 5-fluorouracil-based chemotherapy);
  • In locally advanced, recurrent, or metastatic, non-squamous, non-small cell lung cancer (in combination with carboplatin and paclitaxel);
  • In patients with previously untreated metastatic HER2-negative breast cancer (in combination with paclitaxel);
  • In patients with refractory glioblastoma after prior therapy (as a single agent);
  • In patients with metastatic renal cell carcinoma (in combination with interferon alfa).

Avastin side effects: Overview

Some of the more common side effects associated with bevacizumab include high blood pressure, headaches, mouth sores, diarrhea, loss of appetite, fatigue and weakness. Less commonly, the patient might also experience blood clots, neutropenia, shortness of breath, constipation, nausea, abdominal pain, and vomiting. In very rare instances, bevacizumab has caused permanent kidney damage, congestive heart failure, bowel perforation, stroke, and heart attack.3

Avastin and FDA approval

In July of 2010, Avastin was in the news due to new questions about whether or not it should continue to be supported by FDA approval for patients with previously untreated metastatic HER2-negative breast cancer (in combination with paclitaxel). Clinical trials have not shown that the drug extends the lives of breast cancer patients or improves their quality of life.2

Ultimately the FDA will soon decide whether or not to revoke this indication. Even if the FDA revokes approval for Avastin in certain breast cancer patients, Medicare will continue to foot the bill, which is estimated to be about $88,000 per patient on average.

References

  1. NCI: FDA approval of bevacizumab
  2. CancerTreatment.Net: News on Avastin
  3. American Cancer Society: Bevacizumab

Additional Source


 

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