Bevacizumab (Avastin)

Indications


Contraindications

  • Squamous Cell Lung Cancer: due to risk of hemorrhage
  • Central Nervous System Metastases: due to risk of hemorrhage

Pharmacology

  • Monoclonal Ab Which Binds To and Inhibits Vascular Endothelial Growth Factor (VEGF)
    • Inhibits tumoral angiogenesis

Administration

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Adverse Effects

Cardiovascular Adverse Effects

  • Congestive Heart Failure (see Congestive Heart Failure, [[Congestive Heart Failure]])
    • Epidemiology: mostly when bevacizumab is used in combination with anthracyclines, rasing question of true association
  • Hypertension (see Hypertension, [[Hypertension]])

Gastrointestinal Adverse Effects

Hematologic Adverse Effects

  • Increased Risk of Thromboembolic Disease (see Hypercoagulable States, [[Hypercoagulable States]])
    • Epidemiology: 2-fold increased risk
    • Physiology: may be due to vascular injury
  • Thrombotic Microangiopathic Hemolytic Anemia (see Hemolytic Anemia, [[Hemolytic Anemia]])
    • Microangiopathic Hemolytic Anemia (MAHA)
    • Hypertension
    • Renal Failure

Neurologic Adverse Effects

Pulmonary Adverse Effects

  • Pulmonary Hemorrhage from Lung Cancer Tumor Necrosis
    • Prognosis: fatalities have been reported

Other Adverse Effects

  • Impaired Wound Healing
  • Osteonecrosis of the Jaw
  • Ovarian Failure

References

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