Avastin® (bevacizumab) is the first biologic medicine (not a chemotherapy) designed to inhibit angiogenesis. Angiogenesis is
the growth of new blood vessels. This process helps a tumor grow and spread by connecting the tumor to the body’s blood supply.
One of the most expensive drugs that is currently marketed. In many countries with national health services, the use of bevacizumab has been restricted based on cost-benefit calculations that suggest the drug is not cost-effective. One study published in the New England Journal of Medicine reported that bevacizumab extended life by 4.7 months (20.3 months versus 15.6 months) at a cost of $42,800 to $55,000.
% = Percentage of patients who had this side effect in clinical studies across different cancers
UP TO 18% – Severe high blood pressure – Blood pressure that severely spikes or shows signs of affecting the brain.
UP TO 7% – Kidney problems – These may be caused by too much protein in the urine and can sometimes be fatal.
UP TO 2% – SEVERE stroke or heart problems -These may include blood clots, mini-stroke, heart attack, and chest pain. These can sometimes be fatal.
UP TO 0.15 – nervous system and vision problems, Signs include headache, seizure, high blood pressure, sluggishness, confusion, and blindness.
Everyone reacts differently to Avastin therapy. So, it’s important to know what the side effects are. Although some people may have a life-threatening side effect, most do not. Your doctor will stop treatment if any serious side effects occur. Be sure to contact your health care team if there are any signs of these side effects.
Most serious side effects (not common, but sometimes fatal):
- GI perforation. A hole that develops in your stomach or intestine. Symptoms include pain in your abdomen, nausea, vomiting, constipation, or fever
- Wounds that don’t heal. A cut made during surgery can be slow to heal or may not fully heal. Avastin should not be used for at least 28 days before or after surgery and until surgical wounds are fully healed
- Serious bleeding. This includes vomiting or coughing up blood; bleeding in the stomach, brain, or spinal cord; nosebleeds; and vaginal bleeding. If you recently coughed up blood or had serious bleeding, be sure to tell your doctor
Other possible serious side effects:
- Abnormal passage in the body. This type of passage—known as a fistula—is an irregular connection from one part of the body to another and can sometimes be fatal
- Severe high blood pressure. Blood pressure that severely spikes or shows signs of affecting the brain. Blood pressure should be monitored every 2 to 3 weeks while on Avastin and after stopping treatment
- Kidney problems. These may be caused by too much protein in the urine and can sometimes be fatal
- Infusion reactions. These were uncommon with the first dose (less than 3% of patients). 0.2% of patients had severe reactions. Infusion reactions include high blood pressure or severe high blood pressure that may lead to stroke, trouble breathing, decreased oxygen in red blood cells, a serious allergic reaction, chest pain, headache, tremors, and excessive sweating. Your doctor or nurse will monitor you for signs of infusion reactions
- Severe stroke or heart problems. These may include blood clots, mini-stroke, heart attack, chest pain, and your heart may become too weak to pump blood to other parts of your body (congestive heart failure). These can sometimes be fatal
- Nervous system and vision problems. Signs include headache, seizure, high blood pressure, sluggishness, confusion, and blindness
Side effects seen most often:
In clinical studies across different types of cancer, some patients experienced the following side effects:
- High blood pressure 18%
- Too much protein in the urine
- Rectal bleeding
- Back pain
- Taste change
- Dry skin
- Inflammation of the skin
- Inflammation of the nose
- Watery eyes
For Doctors and Caregivers
Most common adverse events
- Across studies, the most common adverse reactions observed in Avastin patients at a rate >10% were:
— Lacrimation disorder
— Back pain
— Exfoliative dermatitis
— Taste alteration
— Dry skin
— Rectal hemorrhage
- Across all studies, Avastin was discontinued in 8% to 22% of patients because of adverse reactions