Avastin

Avastin: Questions & Answers

2006-09-30T07:24:00.000-07:00

What is Avastin (bevacizumab)?

Avastin is a monoclonal antibody.

Antibodies are substances produced by the immune system in response to foreign substances such as bacteria, viruses or toxins. They are the body’s natural defense mechanism against infection, as they help to destroy these foreign substances.

Monoclonal antibodies are antibodies produced in a laboratory to target a very specific part of the foreign substance (antigen). It is expected that monoclonal antibodies may be more effective than standard chemotherapy with fewer side effects.

What is Avastin (bevacizumab)?

Avastin is a monoclonal antibody.

What is Avastin used to treat?

Avastin is used to treat cancer of the colon or rectum that has spread to other parts of the body. Avastin is given along with the chemotherapy combination known as IFL, consisting of irinotecan, 5-fluorouracil (5-FU), and leucovorin. Avastin is given as intravenous injection (into a vein) every 14 days.

Is Avastin a cure for metastatic colorectal cancer?

NO. Avastin will not cure metastatic colorectal cancer.

In clinical trials there was longer survival and tumor control in patients who received the combination of IFL plus Avastin than among those who received IFL without Avastin.

Overall, patients given Avastin survived about five months longer. In addition, the average time before tumors restarted growing or new tumors appeared was four months longer than patients who did not receive Avastin.

Other more common side effects of Avastin treatment are:

What are the possible side effects of Avastin?

Serious side effects include:

holes in the colon requiring surgery to repair (gastrointestinal perforation)
impaired wound healing
bleeding leading to disability (stroke) or death (especially in lung cancer patients)
heart failure in certain patients (those given or receiving other anti-cancer treatments that may injure the heart muscle)
kidney damage

Other more common side effects of Avastin treatment are:

high blood pressure
tiredness / weakness
clot in the vein (thrombophlebitis)
diarrhea
decreased white blood cells
headache
loss of appetite
mouth sores

Side Effects of Avastin

2006-09-30T07:10:00.000-07:00

Source: Patient and Caregiver Resource Centre

Avastin is the first of an innovative class of drugs used to treat cancer of the colon or rectum.

Possible common side effects of therapy

Common side effects associated with chemotherapy:

Diarrhea
Nausea
Vomiting
Loss of appetite
Loss of hair
Tingling or numbness in fingers or toes
Mouth sores
Increased chance of infection
Bleeding or bruising easily
Fatigue
Rash on the hands and feet

Avastin is used in combination with chemotherapy. As such there are additional common side effects associated with Avastin.

Common side effects associated with Avastin:

Nosebleeds
High blood pressure
Too much protein in the urine
Weakness
Pain
Diarrhea
Reduced white blood cell count

Common side effects you may experience with Avastin

In clinical trials for colorectal cancer, the following side effects occurred more often in people receiving Avastin plus chemotherapy than in people receiving just chemotherapy:

Nosebleeds

Nosebleeds were usually minor and stopped on their own by holding a tissue to the nose
Call your doctor if you feel dizzy or faint or if the bleeding doesn't stop after 10 to 15 minutes

Hypertension (high blood pressure)

Standard oral medications were used to manage high blood pressure
Tell your doctor if you've had high blood pressure in the past

Proteinuria (too much protein in the urine)

Other side effects included weakness, pain, diarrhea, and leukopenia (a reduced white blood cell count)

Serious side effects you should know about

· A small percentage of people treated with Avastin in combination with chemotherapy experienced serious side effects, including gastrointestinal perforation (2%) and slow or incomplete wound healing (1%). In rare cases, these side effects have been fatal.

· Patients taking Avastin with chemotherapy had a higher risk of stroke or heart problems compared with people taking chemotherapy alone.

Serious side effects seen in other cancers.

Although Avastin is only approved for colorectal cancer, it has been studied in different types of cancer. What side effects have been seen in lung and breast cancers?

Some people receiving Avastin in combination with chemotherapy for lung cancer experienced serious tumor-related hemorrhage (bleeding)
A small group of people receiving Avastin plus chemotherapy in clinical trials (2% of 1032) experienced congestive heart failure. The majority of these people had taken a type of chemotherapy called anthracyclines (a drug used to treat breast cancer) in the past or in combination with Avastin.

Problems with Avastin

2006-09-30T06:52:00.000-07:00

Source: http://www.rxlist.com/cgi/generic3/avastin.htm

Gastrointesinal Perforations

AVASTIN administration can result in the development of gastrointestinal perforation, in some instances resulting in fatality.

Gastrointestinal perforation, sometimes associated with intra-abdominal abscess, occurred throughout treatment with AVASTIN. The incidence of gastrointestinal perforation (gastrointestinal perforation, fistula formation, and/or intra-abdominal abscess) in patients receiving AVASTIN was 2.4%.

The typical prsentation was reported as abdominal pain associated with symptoms such as constipation and vomiting.

Wound Healing Complications

AVASTIN administration can result in the development of wound dehiscence, in some instances resulting in fatality.

Hemorrhage

Serious, and in some cases fatal, hemoptysis has occurred in patients with non–small cell lung treated with chemotherapy and AVASTIN.

In a small study, the incidence of serious or fatal hemoptysis was 31% in patients with squamous and 4% in patients with adenocarcinoma receiving AVASTIN as compared to no cases in patients treated with chemotherapy alone.

Avastin Warning

2006-09-30T06:47:00.000-07:00

Source: Your Guide to Colon Cancer

FDA and Genentech (the makers of Avastin) warned that patients who take Avastin are at increased risk for the following:

Aterial Thromboembolic Events: Blood clots that break loose, travel through your arteries, and cause serious problems when they get stuck somewhere.

Cerebrovascular Accidents: Strokes that occur when blood supply to the brain is cut off for some reason, like a blood clot. Symptoms include arm or leg weakness and paralysis, speech difficulties, balance problems when walking, numbness or lack of sensation, hand clumsiness, sudden vision loss, confusion, nausea, room spinning, and seizure.

Transient Ischemic Attacks: Strokes that only lasts a few minutes. These are also sometimes referred to as "mini strokes". They occur when the blood supply to the brain is briefly interrupted. Symptoms include numbness or weakness in the face, arm, or leg, especially on one side of the body; confusion or difficulty talking or understanding speech; trouble seeing in one or both eyes; and difficulty walking, dizziness, or loss of balance and coordination.

Myocardial Infarctions: Heart attacks. A blood clot can cause a heart attack if it cuts the flow of blood to the main artery that supplies the heart (coronary artery). Symptoms of a heart attack include pain or discomfort in the center of the chest, arms, back, neck, jaw, or stomach; shortness of breath; breaking out into a cold sweat; and nausea or light-headedness.

Angina: Chest pain. Angina occurs when the heart isn't getting enough blood. It feels like pressure or a squeezing in your chest.