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 and wet macular degeneration by intraocular injection, which is cheaper than Ranibizumab and may offer lower toxicity than that of systemic administration where it also works . It appears to have cardiovascular complications long term when given systemically. A recombinant monoclonal antibody.
- 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. Independent evidence is however accumulating on safety and efficacy in a number of intraocular indications. . It has a higher molecular weight than licensed alternatives meaning it is theoretically less likely to cause systemic side-effects and in intravitreal use has a relatively long half life of 5-10 days. The difference in properties may be important but this needs further study and could go either way in terms of net benefit. Bevacizumab and ranibizumab use was not associated with increased risks of mortality, myocardial infarction, bleeding, or stroke compared with photodynamic therapy or pegaptanib. Ranibizumab may be safer with respect to arterial thrombotic events and severe intraocular inflammation than bevacizumab.
Any condition associated with tissue proliferation.
- Ocular venous occlusive disease
- Cystoid macular oedema
- Proliferative diabetic retinopathy
- Vitreous haemorrhage
- Retinopathy of prematurity
- CNS metastases
- Heart failure
- Gastrointestinal perforation
- Arterial thromboembolism
- ↑ Avery RL, Pearlman J, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, et al. Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology. 2006;113:1695.e1-15. (Direct link – subscription may be required.)
- ↑ Moshfeghi AA, Rosenfeld PJ, Puliafito CA, Michels S, Marcus EN, Lenchus JD, Venkatraman AS. Systemic Bevacizumab (Avastin) Therapy for Neovascular Age-Related Macular Degeneration Twenty-Four-Week Results of an Uncontrolled Open-Label Clinical Study. Ophthalmology. 2006 Oct 4;E pub accessed 14.10.2006
- ↑ Schmucker C, Loke YK, Ehlken C, Agostini HT, Hansen LL, Antes G, Lelgemann M. Intravitreal bevacizumab (Avastin) versus ranibizumab (Lucentis) for the treatment of age-related macular degeneration: a safety review. The British journal of ophthalmology. 2010 Oct 22.(Epub ahead of print) (Link to article – subscription may be required.)
- ↑ Cheng CK, Peng CH, Chang CK, Hu CC, Chen LJ. ONE-YEAR OUTCOMES OF INTRAVITREAL BEVACIZUMAB (AVASTIN) THERAPY FOR POLYPOIDAL CHOROIDAL VASCULOPATHY. Retina (Philadelphia, Pa.). 2011 Feb 11.(Epub ahead of print) (Link to article – subscription may be required.)
- ↑ Shah NJ, Shah UN. Long-term effect of early intervention with single intravitreal injection of bevacizumab followed by panretinal and macular grid photocoagulation in central retinal vein occlusion (CRVO) with macular edema: A pilot study. Eye (London, England). 2011 Feb; 25(2):239-44.(Link to article – subscription may be required.)
- ↑ Hrisomalos FN, Maturi RK, Pata V. Long-term use of intravitreal bevacizumab (avastin) for the treatment of von hippel-lindau associated retinal hemangioblastomas. The open ophthalmology journal. 2010; 4:66-9.(Epub) (Link to article – subscription may be required.)
- ↑ The Intravitreal Use of Bevacizumab (Avastin) in AMD. The Royal College of Ophthalmologists accessed 1 Aug 2007
- ↑ Meyer CH, Holz FG. Preclinical aspects of anti-VEGF agents for the treatment of wet AMD: ranibizumab and bevacizumab. Eye (London, England). 2011 Apr 1.(Epub ahead of print) (Link to article – subscription may be required.)
- ↑ Curtis LH, Hammill BG, Schulman KA, Cousins SW. Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Archives of ophthalmology. 2010 Oct; 128(10):1273-9.(Link to article – subscription may be required.)
- ↑ Carneiro AM, Barthelmes D, Falcão MS, Mendonça LS, Fonseca SL, Gonçalves RM, Faria-Correia F, Falcão-Reis FM. Arterial thromboembolic events in patients with exudative age-related macular degeneration treated with intravitreal bevacizumab or ranibizumab. Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift für Augenheilkunde. 2011; 225(4):211-21.(Link to article – subscription may be required.)
- ↑ Mitchell P, Annemans L, White R, Gallagher M, Thomas S. Cost effectiveness of treatments for wet age-related macular degeneration. PharmacoEconomics. 2011 Feb 1; 29(2):107-31.(Link to article – subscription may be required.)
- ↑ Regulatory Decision to Withdraw Avastin (bevacizumab) Firstline Metastatic Breast Cancer Indication
- ↑ Mintz-Hittner HA, Kennedy KA, Chuang AZ. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. The New England journal of medicine. 2011 Feb 17; 364(7):603-15.(Link to article – subscription may be required.)