Bevacizumab

From Ganfyd

Bevacizumab is a humanised monoclonal antibody against vascular endothelial growth factor (VEGF). VEGF-mediated angiogenesis is thought to sustain the growth of many cancers and this is the rationale behind targetting VEGF. It is also a promising drug in treating proliferative diabetic retinopathy^[1] and wet macular degeneration by intraocular injection, which is likely to be cheaper than Ranibizumab and may offer lower toxicity than that of systemic administration where it also works ^[2]. It appears to have cardiovascular complications long term when given systemically. A recombinant monoclonal antibody.

Indication

• Licensed for metastatic carcinoma of the colon or rectum.
• Combination with interferon alfa-2a in renal cell cancer
• There has been use for intravitreal use of bevacizumab wet age-related macular degeneration but the drug is not licensed for this indication and there is no evidence that the license holder intends to sponsor the studies necessary for this to occur. There is no long-term information on safety and efficacy. A review of evidence for its use in this indication in the UK was published in 2007^[3].

Possible indications

Any condition associated with tissue proliferation.

• Malignancies
• Rubeosis
• Ocular venous occlusive disease
• Cystoid macular oedema
• Proliferative diabetic retinopathy
• Vitreous haemorrhage

Contraindications

• Pregnancy
• CNS metastases
• Hypersensitivity

Side-effects

• Hypertension
• Heart failure
• Gastrointestinal perforation
• Proteinuria
• Arterial thromboembolism
• Haemorrhage
• Neutropenia

References