Avastin (bevacizumab), a Genentech cancer medication, interferes with the growth and spread of cancer cells in the body. Avastin is approved to be used alone or with other medications to treat different types of cancers. These include cervical cancer, colorectal cancer, glioblastoma (a type of brain cancer), non-small cell lung cancer (NSCLC), ovarian epithelial, fallopian tube, primary peritoneal cancer, and renal (kidney) cell cancer. Avastin is also being studied in the treatment of other types of cancers.
In combination with the chemotherapies Paraplatin (carboplatin) and Taxol (paclitaxel), is approved to treat advanced NSCLC in people who have not previously received chemotherapy for their advanced disease.
How Avastin works
The blood supply (containing food and oxygen) is essential for the growth and survival of cancer cells. Binding Avastin to VEGF inhibits the interaction between VEGF and its receptor, thereby preventing the growth and maintenance of tumor blood vessels. As a result, Avastin-mediated inhibition of blood vessel growth cuts off nutrients to cancer cells, resulting in their death.
Avastin in clinical studies
The approval of Avastin by the U.S. Food and Drug Administration (FDA) for the treatment of NSCLC was based on the results of a randomized, controlled, multi-center trial (NCT00021060) that enrolled 878 patients with advanced, metastatic or recurrent NSCLC. The results showed that Avastin, in combination with Taxol and Paraplatin, leads to a significant improvement (about 25 percent) in overall survival compared to patients who received only Taxol and Paraplatin.
One-year survival was 51 percent in the Avastin plus chemotherapy arm compared to 44 percent in the chemotherapy-alone arm. The median survival was 12.3 months in the group treated with Avastin plus chemotherapy, compared to 10.3 months in the chemotherapy-alone group.
It is infused as a drip into the bloodstream. The drug is given once every three weeks to treat lung cancer. The first dose takes over 90 minutes and the time decreases to 60 minutes for the second dose and 30 minutes for the third dose.
Several tests are performed before starting the treatment to check the patients’ blood cell count and liver and kidney functions.
Warnings and precautions
It may interact with some other medicines, vitamins, herbal supplements, and over-the-counter medications. It may cause infertility and it is advised to avoid pregnancy while taking Avastin since it may harm the developing fetus. Breastfeeding is not advisable during treatment and for six months afterward. Avastin can make wounds heal more slowly, so it is better to avoid the drug after surgery or until wounds have completely healed.
Serious side effects include the formation of holes in the stomach or intestine, slow wound healing, and serious bleeding episodes.
Other side effects include high blood pressure, too much protein in the urine, nosebleeds, unusual bleeding, back pain, headache, taste changes, dry skin, skin and nose inflammation, and watery eyes.
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