bevacizumab at a glance
Medicine class
Anti-VEGF humanised monoclonal antibody
Usual role
Targeted treatment for selected advanced or metastatic cancers, usually alongside other systemic treatments
How it is given
A healthcare professional gives it as a slow infusion into a vein
Routine checks
Blood pressure and urine protein are checked before and during treatment
What is bevacizumab used for?
The selected Alymsys product is licensed for adults in defined combinations and clinical settings.
Metastatic cancer of the colon or rectum.
First-line treatment of selected metastatic breast cancer.
First-line treatment of unresectable advanced, metastatic or recurrent non-squamous non-small-cell lung cancer, including a defined EGFR-mutated setting.
First-line treatment of advanced or metastatic renal cell cancer.
Advanced or recurrent epithelial ovarian, fallopian-tube or primary peritoneal cancer in defined settings.
Persistent, recurrent or metastatic cervical cancer.
Specialist services may also use bevacizumab outside its licence for NF2-related schwannomatosis or in eye care. Alymsys is not formulated or authorised for injection into the eye.
How does bevacizumab work?
VEGF stimulates new blood-vessel growth. Bevacizumab binds VEGF and prevents it activating receptors on endothelial cells, limiting new tumour blood vessels and reducing the tumour’s vascular supply.
bevacizumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 25 mg/mL, 100 mg, 100 mg/4 mL, 400 mg, 400 mg/16 mL
How to take bevacizumab
Bevacizumab is not taken by mouth. A specialist team dilutes the concentrate and gives it through a vein while monitoring for hypersensitivity or infusion reactions.
Tell staff immediately about breathlessness, flushing, rash, swelling, chest discomfort, dizziness, chills, nausea or vomiting during an infusion.
Tell your oncology team before planned surgery, invasive dental treatment or treatment by another clinical service.
The selected concentrate must not be injected directly or given as an intravenous push.
bevacizumab side effects
Common or expected effects
- High blood pressure
- Tiredness or weakness
- Diarrhoea, nausea, vomiting or abdominal discomfort
- Constipation or reduced appetite
- Headache
- Nosebleeds
- Sore mouth or mucosal inflammation
- Protein in the urine
- Numbness or tingling in the hands or feet; some effects may also reflect accompanying cancer treatment
Get urgent medical advice
- Difficulty breathing, swelling, collapse or chest pain during or after an infusion
- Heavy or unusual bleeding, coughing blood, black stools or blood in vomit
- Severe abdominal pain, fever or persistent vomiting, which may indicate perforation or fistula
- Chest pain, sudden breathlessness, one-sided weakness, speech difficulty or a painful swollen limb, which may indicate a blood clot
- Severe headache with visual disturbance, confusion or seizures
- Very high blood pressure with neurological symptoms
- Poor wound healing or a spreading painful skin infection
- Sudden severe chest, back or abdominal pain, which can indicate an arterial tear or ruptured aneurysm
bevacizumab in pregnancy
Bevacizumab is contraindicated during pregnancy because blocking blood-vessel formation could seriously harm fetal development. Effective contraception is required during treatment and for at least six months afterwards. Tell the specialist immediately about pregnancy or plans to conceive. Female fertility may be impaired, so discuss fertility preservation before treatment where relevant.
bevacizumab while breastfeeding
Breastfeeding must stop during treatment and should not restart for at least six months after the last administration because harm to infant growth and development cannot be excluded. Discuss feeding options with the cancer and maternity teams.
bevacizumab interactions
The oncology team should review all prescribed, over-the-counter and complementary treatments.
Sunitinib
The combination has caused microangiopathic haemolytic anaemia, hypertension, kidney impairment and neurological toxicity and should be avoided.
Cetuximab or panitumumab
Combining an EGFR monoclonal antibody with bevacizumab-containing chemotherapy for metastatic colorectal cancer increased toxicity and produced worse clinical outcomes.
Platinum- or taxane-based treatments
Some combinations have increased severe neutropenia, fever associated with neutropenia and infection.
Common questions about bevacizumab
Answers are fully visible for fast scanning and source review.
Is bevacizumab chemotherapy?
No. It is a targeted biological monoclonal antibody that blocks VEGF, although it is commonly given alongside chemotherapy or another targeted treatment.
Why are blood pressure and urine checked?
Bevacizumab can raise blood pressure and cause protein to leak into the urine, so both are monitored before and during treatment.
Why must I tell my surgeon or dentist?
Bevacizumab can impair wound healing and increase bleeding risk, so surgery and invasive dental procedures require advance planning with the oncology team.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.