Bevacizumab is a vascular endothelial growth factor-specific angiogenesis inhibitor indicated for the treatment of:
Metastatic colorectal cancer, in combination with intravenous 5-fluorouracil–based chemotherapy for first- or second-line treatment.
Metastatic colorectal cancer, in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin-based chemotherapy for second-line treatment in patients who have progressed on a first-line Bevacizumab-containing regimen.
Non-squamous non-small cell lung cancer, in combination with carboplatin and paclitaxel for first-line treatment of unresectable, locally advanced, recurrent, or metastatic disease.
Glioblastoma, as a single agent for adult patients with progressive disease following prior therapy. The effectiveness of Bevacizumab is based on improvement in objective response rate. No data is available demonstrating improvement in disease-related symptoms or survival with Bevacizumab.
Metastatic renal cell carcinoma, in combination with interferon alfa.
Cervical cancer, in combination with paclitaxel and cisplatin or paclitaxel and topotecan in persistent, recurrent, or metastatic disease.
Recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, that is:
Platinum-resistant, in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan.
Platinum-sensitive, in combination with carboplatin and paclitaxel or in combination with carboplatin and gemcitabine, followed by Bevacizumab as a single agent.
Bevacizumab is not indicated for the adjuvant treatment of colon cancer.
Do not administer as an IV push or bolus.
Do not initiate Bevacizumab for 28 days following major surgery (until the surgical wound is fully healed).
First infusion: Administer over 90 minutes.
Subsequent infusions: Administer the second infusion over 60 minutes if the first infusion is tolerated; administer all subsequent infusions over 30 minutes if the infusion over 60 minutes is tolerated.
Recommended Doses and Schedules
Patients should continue treatment until disease progression or unacceptable toxicity.
Metastatic Colorectal Cancer (mCRC):
5 mg/kg or 10 mg/kg every 2 weeks when used in combination with intravenous 5-FU-based chemotherapy.
5 mg/kg when used in combination with bolus-IFL.
10 mg/kg when used in combination with FOLFOX4.
5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks when used in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin-based chemotherapy in patients who have progressed on a first-line Bevacizumab-containing regimen.
Non-Squamous Non-Small Cell Lung Cancer (NSNSCLC): 15 mg/kg every 3 weeks, in combination with carboplatin and paclitaxel.
Glioblastoma: 10 mg/kg every 2 weeks.
Metastatic Renal Cell Carcinoma (mRCC): 10 mg/kg every 2 weeks, in combination with interferon alfa.
Cervical Cancer: 15 mg/kg every 3 weeks as an intravenous infusion in combination with paclitaxel and cisplatin or paclitaxel and topotecan.
Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer: 10 mg/kg every 2 weeks, in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly).
15 mg/kg every 3 weeks, in combination with topotecan (every 3 weeks).
Platinum-Sensitive Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer: 15 mg/kg every 3 weeks, in combination with carboplatin and paclitaxel for 6–8 cycles, followed by continued Bevacizumab as a single agent until disease progression.
15 mg/kg every 3 weeks, in combination with carboplatin and gemcitabine for 6–10 cycles, followed by continued Bevacizumab as a single agent until disease progression.
Use appropriate aseptic techniques. Parenteral drug products should be visually inspected for particulate matter and discoloration before administration, whenever the solution and container permit. Withdraw the necessary amount of Bevacizumab and dilute it in a total volume of 100 mL of 0.9% Sodium Chloride Injection, USP. Discard any unused portion left in a vial, as the product contains no preservatives.
Dosage Forms and Strengths
100 mg/4 mL, single-use vial
400 mg/16 mL, single-use vial
Perforation or Fistula: Discontinue Bevacizumab if perforation or fistula occurs.
Arterial Thromboembolic Events (ATE) (e.g., myocardial infarction, cerebral infarction): Discontinue Bevacizumab for severe ATE.
Venous Thromboembolic Events (VTE): Discontinue Bevacizumab for life-threatening VTE.
Hypertension: Monitor blood pressure and treat hypertension. Temporarily suspend Bevacizumab if not medically controlled. Discontinue Bevacizumab for hypertensive crisis or hypertensive encephalopathy.
Posterior Reversible Encephalopathy Syndrome (PRES): Discontinue Bevacizumab.
Proteinuria: Monitor urine protein. Discontinue Bevacizumab for nephrotic syndrome. Temporarily suspend Bevacizumab for moderate proteinuria.
Infusion Reactions: Stop Bevacizumab for severe infusion reactions.
Embryo-fetal Toxicity: Advise females of the potential risk to a fetus and the need for effective contraception.
Ovarian Failure: Advise females of the potential risk.
Store Bevacizumab® vials in a refrigerator at 2–8°C. Keep the vial in the outer carton to protect it from light. Do not freeze.
