Bevacizumab is monoclonal antibody against VEGF-A (vascular endothelial growth factor A). VEGF is a growth factor highly expressed in tumor cells. Inhibition of VEGF by Bevacizumab results in decreased angiogenesis (blood vessels) in cancer tumors.

Metastatic colon cancer (with 5FU based chemotherapy), metastatic non-small cell lung cancer (with carboplatin and taxol), metastatic renal cell carcinoma, metastatic ovarian cancer.

Two phase III studies investigated the role of bevacizumab (Avastin) in metastatic breast cancer (see references below). Adding Avastin to capecitabine in treatment of women with metastatic breast cancer didn't resulted in prolongation of life of these patients, nor resulted in slowing of the disease progression. In another study by Miller et al., adding Avastin to paclitaxel (Taxol) in treatment of women with metastatic breast cancer resulted in slowing of disease progression but didn't resulted in prolongation of life of these patients, nor in improvement in quality of life. Hence many clinicians think that giving Avastin in breast cancer is not justified relying upon the current data.

Hypertension, proteinuria (kidney disease), bowel perforation/ fistula, coagulation problems (thrombosis, and bleeding- e.g. nose bleeding), headache.

Intravenous

Genentech, Inc., South San Francisco, CA

1.    Hurwitz HI, Fehrenbacher L, Hainsworth JD, Heim W, Berlin J, Holmgren E, Hambleton J, Novotny WF, Kabbinavar F. Bevacizumab in combination with fluorouracil and leucovorin: an active regimen for first-line metastatic colorectal cancer. J Clin Oncol. 2005; 23 (15):3502-8. Press to view article abstract

2.    Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006; 355 (24):2542-50. Press to view article abstract

3.    Yang JC, Haworth L, Sherry RM, Hwu P, Schwartzentruber DJ, Topalian SL, Steinberg SM, Chen HX, Rosenberg SA. A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med. 2003; 349 (5):427-34. Press to view article abstract

4.    Rini BI. Vascular endothelial growth factor-targeted therapy in renal cell carcinoma: current status and future directions. Clin Cancer Res. 2007; 13 (4):1098-106. Press to view article abstract

5.    Burger RA. Experience with bevacizumab in the management of epithelial ovarian cancer. J Clin Oncol. 2007; 25 (20):2902-8. Press to view article abstract

6.    Larkin JM, Chowdhury S, Gore ME. Drug insight: advances in renal cell carcinoma and the role of targeted therapies. Nat Clin Pract Oncol. 2007; 4 (8):470-9.Press to view article abstract

7.    Miller K. et al. Randomized Phase III Trial of Capecitabine Compared With Bevacizumab Plus Capecitabine in Patients With Previously Treated Metastatic Breast Cancer. Journal of Clinical Oncology, 23: 792-799 (2005). Press here to view the article abstract.

8.    Miller K. et al. Paclitaxel plus Bevacizumab versus Paclitaxel Alone for Metastatic Breast Cancer. N Engl J Med. 357:2666-2676 (2007). Press here to view the article abstract.

Internet Links: