Avastin is an antitumor drug of a new generation, based on the targeted effect on a tumor of humanized monoclonal antibodies. The agent suppresses the growth of its own capillary tumor network, which stops the process of aggressive growth.
Form release, composition and packaging
Avastin is issued in the form of powder, packed in vials, placed in cardboard packages. Vials contain bevacizumab:
- in a 4 ml vial - 100 mg;
- in a vial of 16 ml - 400 mg.
Producer of medicines
Produced by Hoffmann-La Roche,( Switzerland), German company Roche, American Genentech.
Indications for use
The drug is used against:
- colorectal cancer;
- breast tumors;
- of inoperable lung cancer;
- of renal cancer;
- glioblastoma.
- Individual sensitivity;
- pregnancy;
- child's age;
- diseases of the kidneys, liver.
Contraindications
Restrictions on use are due to a lack of safety data. Inadequate information about the features of the drug's action is explained by contraindications in childhood.
Use caution to treat patients suffering from:
- hypertension;
- with coagulopathy;
- by proteinuria;
- neutropenia;
- with leukoencephalopathy.
With caution, it is prescribed to persons who underwent thromboembolism, gastrointestinal perforation, after age 65, when taking anticoagulants.
Mechanism of action of the preparation
Bevacizumab is represented by recombinant monoclonal antibodies( IgG), approximated to human.
The agent is attached to the growth factor of the endothelial capillary membrane( VEGF), blocks the growth of blood vessels. VEGF is a protein that triggers the germination processes in the tissue of the capillary network.
The process of formation of blood vessels is necessary for the restoration and renewal of healthy tissues, but this mechanism also supports the growth of a cancerous tumor, supplying food to cancer cells, like all other cells of the body.
Instructions for use Avastin
When taking the dosage, it is taken into account that the rate of excretion of Avastin from the body:
- is increased by 30% with a lack of albumin;
- is 7% higher in patients with extensive tumors.
Metastatic colon cancer
Avastin is used as a drug of choice in colorectal cancer - tumors of the large intestine, rectum, appendix. The incidence of colorectal cancer in Russia is 50 thousand patients per year.
Avastin is prescribed as a part of complex treatment:
- 5 mg / kg after 14 days with fluorouracil, leukovarine.
- 7.5 mg / kg after 21 days with simultaneous use of capecitabine, oxaliplatin.
- 5 mg / kg after 14 days with drugs leucovorin, fluorouracil, then fluorouracil, oxaliplatin.
- 10 mg / kg every 14 days in combination with leucovorin, fluorouracil, then replacing leucovorin with oxaliplatin without changing fluorouracil.
Avastin with chemotherapy gives a statistically significant increase in survival rates.
Breast cancer
Avastin is used as the first line of defense for breast cancer at a dose of 10 mg / kg every 14 days.
The drug is given in combination with paclitaxel, which increases the period of remission.
In combination with docetaxel, Avastin is used at a concentration of 7.5 mg / kg, 15 mg / kg at 3 weeks in patients who have not previously received chemotherapy, statistically increases the survival and duration of a stable condition without progression of the disease.
Carcinoma of the lung
The drug is used with a common, recurring non-squamous, inoperable cancer. The drug is prescribed in dosages of 7, 5 mg / kg, 15 mg / kg, treatment is carried out every 21 days.
The following treatment regimens are used:
- Avastin with cisplatin, carboplatin;
- Conduct 6 courses of chemotherapy with platinum drugs, after which they are treated with Avastin.
Renal cell carcinoma
In the treatment of renal cell carcinoma Avastin with interferon is the first line of defense.
The drug is often used in the treatment of kidney cancer, it is also used as a monotherapy. Avastin is prescribed 10 mg / kg every 14 days.
Glyoblastoma
Bevacizumab is active against an aggressive brain tumor of glioma. Using Avastin in the form of monotherapy or in combination with irinotecan reduces the severity of symptoms and improves survival, reducing the growth rate of the tumor.
Ovarian carcinoma
For ovarian cancer, fallopian tubes, peritoneum, the drug is administered after 3 weeks at a dosage of 15 mg / kg of the patient.
For treatment, the following regimens are used:
- Avastin + paclitaxel + carboplatin for 6 courses, then Avastin monotherapy;
- for 6 courses of Avastin + gemcitabine + carboplatin, followed by monotherapy with Avastin.
Side effects of
A particular danger when taking a drug containing bevacizumab is:
- perforation of the stomach, intestines;
- hemoptysis( with lung cancer);
- arteries thromboembolism.
Side effects of varying severity are noted on the part of all organ systems.
Heart, vessels
Adverse effects of Avastin are manifested:
- hypertension;
- infarction;
- ischemia;
- stroke;
- with vein thrombosis, arteries;
- tachycardia;
- heart failure.
hematopoiesis
- Decreased number of leukocytes, platelets, neutrophils;
- anemia.
Digestive tract
- Stool disorder;
- vomiting;
- perforation, bleeding from the intestine, stomach;
- anorexia;
- intestinal obstruction.
Respiratory system
- Runny nose;
- dysphonia;
- bleeding from the nose;
- perforation of the septum of the nose;
- shortness of breath;
- pulmonary thromboembolism.
Nervous system, sense organs
- Perversion of taste;
- vision impairment;
- headache;
- drowsiness;
- encephalopathy;
- epileptic seizure;
- is a mental disorder.
Urinary system
There is a loss of protein in the urine( proteinuria), renal microangiopathy, increases the likelihood of infection. Laboratory tests reveal dehydration of the body.
Cutaneous, local reactions
- Pain may be felt at the injection site;
- dermatitis;
- dry skin;
- appearance of palmar-plantar syndrome.
Overdose
In the case of an overdose of the drug in patients develops a headache, aggravated side effects. To eliminate the phenomena caused by an overdose, the symptomatic treatment performed by the health worker is carried out.
Special instructions
The prepared solution is used immediately, observing sterility. If part of the drug remains, then the remainder of the prepared solution should be stored at a temperature of + 20C - + 80C not longer than a day.
Especially cautious treatment of patients suffering:
- intra-abdominal inflammation due to the possibility of perforation of the digestive tract;
- by intestinal cancer - fistula formation is possible;
- a breast tumor - a threat of heart failure is created.
Treatment with large doses of bevacizumab creates an increased risk of high blood pressure, bleeding from the gums. In patients after 60 years, the risk of thromboembolism increases.
Up to six months after Avastin therapy, contraception is used during sexual intercourse, and the possibility of conception is excluded. Breastfeeding during treatment is discontinued. The break should last at least six months.
In case of drowsiness, it is not recommended to drive vehicles.
Drug Interaction
Bevacizumab enhances the action of cytostatics, increases the toxicity of Cetuximab, Panitumab when applied simultaneously.
With Sunitinib Malate Avastin increases the risk of hemolytic anemia, with taxanes, platinum drugs, the agent increases the likelihood of infectious diseases, increases the risk of death.
It is not recommended to be treated with Avastin with capecitabine after treatment with taxanes + anthracyclines.
Reviews of patients with
Reviews of patients are reduced to the severity of symptoms associated with treatment. Frequent phenomena that occur when taking Avastin are hypertension, headache.
Price in Moscow
Means for the preparation of medication for intravenous administration:
- 16 ml( 400 mg bevacizumab) - price 46800 rubles;
- 4 ml( 100 ml bevacizumab) - the cost is 16,410 rubles.
Analogues Avastin
MabThera, Alimta, Vectibix have a similar effect on the tumor. Synonyms for active ingredient - Bevacizumab, Avedra Biocad.
Conditions for the release of
Avastin is sold by prescription.
Storage Conditions, Shelf Life
Avastin is stored at a temperature from + 20C to + 80C for not more than 2 years. Shaking, freezing of the drug is prohibited.
Video about Avastin treatment for breast cancer: