What is Bevacizumab: Uses, Dosage, Side Effects and More

Bevacizumab is a targeted cancer medication that helps fight certain types of cancer by cutting off their blood supply. This medicine works by blocking a protein called VEGF that helps tumors grow new blood vessels to feed themselves.

Your doctor might recommend bevacizumab if you have specific cancers like colorectal, lung, kidney, or brain tumors. It's always given through an IV in a hospital or clinic setting, where medical professionals can monitor you closely throughout the treatment.

What is Bevacizumab?

Bevacizumab is a laboratory-made antibody that targets cancer cells in a very specific way. Think of it as a highly trained guard that recognizes and blocks certain signals that cancer cells use to grow and spread.

This medication belongs to a class of drugs called angiogenesis inhibitors, which means it stops the formation of new blood vessels. Cancer cells need a constant supply of nutrients and oxygen through blood vessels to survive and multiply. By blocking this blood supply, bevacizumab essentially starves the tumor.

The drug is also known by its brand name Avastin and comes as a clear liquid that healthcare providers mix with saline solution. It's considered a monoclonal antibody, which means it's designed to target one specific protein in your body.

What is Bevacizumab Used For?

Bevacizumab treats several types of advanced cancers, often in combination with other cancer medications. Your oncologist will determine if this treatment is right for your specific situation based on your cancer type and stage.

Here are the main cancers where bevacizumab might help:

• Colorectal cancer that has spread to other parts of your body
• Non-small cell lung cancer in advanced stages
• Kidney cancer (renal cell carcinoma)
• Brain tumors, specifically glioblastoma
• Cervical cancer that has returned or spread
• Ovarian cancer that has come back after initial treatment

Your doctor might also consider bevacizumab for other cancer types in clinical trials or special circumstances. The medication is rarely used alone and typically works alongside chemotherapy drugs to enhance their effectiveness.

How Does Bevacizumab Work?

Bevacizumab works by targeting a protein called vascular endothelial growth factor, or VEGF for short. This protein acts like a signal that tells your body to create new blood vessels, which is normally a healthy process.

Cancer cells hijack this natural process by producing excess VEGF to build their own blood vessel network. These new vessels deliver oxygen and nutrients that help tumors grow larger and potentially spread to other parts of your body.

When bevacizumab enters your system, it binds to VEGF proteins and prevents them from sending their blood vessel-building signals. This process essentially cuts off the tumor's food supply, causing it to shrink or stop growing.

The medication is considered moderately strong and typically shows effects within a few treatment cycles. However, it works differently than traditional chemotherapy drugs that directly kill cancer cells.

How Should I Take Bevacizumab?

Bevacizumab is always given through an intravenous (IV) line in a hospital, clinic, or cancer treatment center. You cannot take this medication at home or by mouth, as it needs to be carefully prepared and monitored by healthcare professionals.

Your treatment will typically follow this process: First, a nurse will insert an IV line into your arm or access your port if you have one. The medication is then mixed with saline solution and given slowly over 30 to 90 minutes.

Before each infusion, you don't need to avoid food or drink unless your doctor gives you specific instructions. However, staying well-hydrated by drinking plenty of water in the days leading up to treatment can help your body process the medication better.

You'll receive bevacizumab every 2 to 3 weeks, depending on your treatment plan. Each session might take 2 to 4 hours total, including preparation time and monitoring afterward.

How Long Should I Take Bevacizumab For?

The length of your bevacizumab treatment depends on how well your cancer responds and how your body tolerates the medication. Most people receive treatment for several months, though some may need it for a year or longer.

Your oncologist will monitor your progress through regular scans and blood tests to determine when to continue, adjust, or stop treatment. If your cancer shrinks or stops growing without serious side effects, you might continue treatment for an extended period.

Some people may need to pause treatment temporarily if they develop certain side effects, then resume once these issues resolve. Your doctor will work with you to find the right balance between fighting your cancer and maintaining your quality of life.

What Are the Side Effects of Bevacizumab?

Like all cancer medications, bevacizumab can cause side effects, though not everyone experiences them. Most side effects are manageable with proper medical care and monitoring.

Common side effects that many people experience include:

• High blood pressure that your doctor will monitor closely
• Fatigue that might make you feel more tired than usual
• Headaches that can often be managed with over-the-counter pain relievers
• Nausea that might affect your appetite
• Diarrhea or changes in bowel movements
• Nosebleeds or minor bleeding that stops easily
• Changes in taste that might make food taste different

These everyday side effects usually improve as your body adjusts to the medication, and your healthcare team has many ways to help manage them.

Less common but more serious side effects require immediate medical attention and include:

• Serious bleeding that doesn't stop easily
• Blood clots that might cause leg pain or breathing problems
• Severe high blood pressure with symptoms like severe headache or vision changes
• Kidney problems that might cause swelling or changes in urination
• Heart problems that might cause chest pain or shortness of breath
• Bowel perforation, which causes severe abdominal pain

Your medical team will monitor you carefully for these more serious effects and teach you warning signs to watch for between treatments.

Rare but serious complications that occur in a small percentage of patients include:

• Severe wound healing problems that might delay surgery
• Reversible posterior leukoencephalopathy syndrome (RPLS), which affects the brain
• Severe protein in the urine (proteinuria)
• Congestive heart failure in people with existing heart conditions
• Severe allergic reactions during infusion

While these rare effects sound concerning, your healthcare team is trained to recognize and manage them quickly if they occur.

Who Should Not Take Bevacizumab?

Bevacizumab isn't safe for everyone, and your doctor will carefully review your medical history before recommending this treatment. Certain health conditions or circumstances make this medication too risky.

You should not receive bevacizumab if you have:

• Recent surgery within the past 28 days, as it can interfere with wound healing
• Active bleeding or a history of serious bleeding disorders
• Severe, uncontrolled high blood pressure
• Recent heart attack or stroke
• Serious kidney disease or proteinuria
• Known allergy to bevacizumab or similar medications

Your doctor will also exercise extra caution if you have heart disease, blood clotting disorders, or a history of bowel problems. These conditions don't automatically disqualify you from treatment, but they require closer monitoring.

If you're pregnant or breastfeeding, bevacizumab is not recommended as it can harm your developing baby. Your healthcare team will discuss safe contraception methods if you're of childbearing age.

Bevacizumab Brand Names

Bevacizumab is most commonly known by its brand name Avastin, which is the original version developed by Genentech. This is the name you'll most likely hear from your healthcare team and see on your treatment paperwork.

Several biosimilar versions of bevacizumab have been approved and may be available at your treatment center. These include Mvasi, Zirabev, and Alymsys, which work the same way as the original Avastin.

Biosimilars are highly similar to the original medication and have the same effectiveness and safety profile. Your doctor or pharmacist might use any of these names when discussing your treatment, but they all refer to the same type of medication.

Bevacizumab Alternatives

If bevacizumab isn't right for you or stops working effectively, your oncologist has several alternative treatment options. The best choice depends on your specific cancer type and your overall health condition.

Other angiogenesis inhibitors that work similarly include:

• Ramucirumab (Cyramza) for stomach and lung cancers
• Sunitinib (Sutent) for kidney cancer
• Sorafenib (Nexavar) for liver and kidney cancers
• Pazopanib (Votrient) for kidney cancer

Your doctor might also consider immunotherapy drugs, different chemotherapy combinations, or targeted therapy pills depending on your situation. Each alternative has its own benefits and side effect profile.

Clinical trials often offer access to newer medications that aren't yet widely available. Your oncologist can help you explore these options if standard treatments aren't suitable.

Is Bevacizumab Better Than Other Cancer Medications?

Bevacizumab isn't necessarily better or worse than other cancer medications, but rather serves a different purpose in your treatment plan. It's often most effective when combined with traditional chemotherapy drugs rather than used alone.

Compared to chemotherapy alone, adding bevacizumab can help shrink tumors more effectively and sometimes helps people live longer. However, it also adds potential side effects that your medical team must carefully manage.

The "best" treatment for you depends on many factors including your cancer type, stage, overall health, and personal preferences. Your oncologist will consider all these factors when creating your personalized treatment plan.

Some people do better with bevacizumab combinations, while others might benefit more from different approaches like immunotherapy or targeted therapy pills. There's no one-size-fits-all answer in cancer treatment.