Avastin

Avastin is the brand name for bevacizumab, a humanized monoclonal antibody that targets vascular endothelial growth factor A (VEGF-A). By binding VEGF-A, it prevents activation of VEGF receptors on blood vessels, reducing angiogenesis and tumor blood vessel growth. It is used as an anticancer therapy and is approved for several solid tumors.

Approved indications include metastatic colorectal cancer, non-squamous non-small cell lung cancer, glioblastoma, metastatic renal cell carcinoma, and epithelial ovarian, fallopian tube, and primary peritoneal cancer. It is also approved for cervical cancer and certain other gynecologic cancers, typically in combination with chemotherapy. In hepatocellular carcinoma, bevacizumab is used as part of combination therapy with atezolizumab in a regimen studied for unresectable disease. Bevacizumab may be used in various regimens depending on cancer type and line of therapy; it is generally given with chemotherapy or as part of combination regimens and is continued until disease progression or unacceptable toxicity.

Administration is by intravenous infusion, with dosing and schedule differing by indication (commonly every two or three weeks). Treatment decisions consider potential benefits versus risks, including the need for monitoring blood pressure and kidney function.

Warnings and adverse effects are significant and include hypertension, proteinuria, wound healing impairment, arterial and venous thromboembolism, serious hemorrhage, gastrointestinal perforation, and reversible posterior leukoencephalopathy syndrome. Wound healing impairment can affect surgical procedures; use around surgery requires careful timing. Common side effects also include fatigue, headaches, and infusion reactions.

Biosimilars such as bevacizumab-awwb (Mvasi) and other biosimilars are approved for oncology indications. Avastin was developed by Genentech (a Roche subsidiary), with its initial FDA approval in 2004 for metastatic colorectal cancer.