Bevacizumab

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The active ingredient bevacizumab is one of the most important drugs in cancer: It is used in the treatment of colon, breast, pancreatic and prostate cancer. It is generally considered to be relatively well tolerated, but in rare cases it can lead to bleeding, high blood pressure and severe skin reactions. Children and adolescents should only be given drugs containing bevacizumab after carefully weighing the risks and benefits. Here you can read everything you need to know about bevacizumab.

This is how bevacizumab works

Genetic predisposition or environmental factors such as smoking, stress or chemicals can develop cancer in the course of life: body cells begin to grow in an uncontrolled manner, to multiply and to displace healthy tissue - a malignant tumor develops. The cells of the tumor are “immortal”, which means that, unlike normal cells, they can divide again and again. Normal cells naturally lose their ability to divide at some point.

Some tumors can split off cells and “spread” around the body. These aggressive cells migrate to other parts of the body via the bloodstream or the lymphatic system, where they form what are known as metastases (offshoots or daughter tumors of the original tumor). The tumor affects the entire body - in the end stage cancer is usually fatal.

In order to grow, the tumor needs its own blood supply, as it needs a particularly large amount of nutrients and oxygen for rapid tissue growth. To do this, it independently forms the messenger substance VEGF in large quantities, which after binding to its docking point (receptor) promotes the formation of blood vessels.

The genetically engineered antibody bevacizumab blocks these receptors. As a result, the growth-promoting messenger substance VEGF can no longer bind to it, and the formation of blood vessels (angiogenesis) is stopped. Bevacizumab therefore belongs to the so-called group of angiogenesis inhibitors. Due to the impaired supply of oxygen and nutrients, the tumor can no longer grow.

Uptake, degradation and excretion of bevacizumab

Bevacizumab is given directly into the bloodstream via an infusion. The active ingredient is then quickly distributed throughout the body. Since bevacizumab has a protein structure, it can be slowly broken down anywhere in the body.

When is bevacizumab used?

The areas of application (indications) for bevacizumab include:

Colon cancer
Breast cancer
Lung cancer (bronchial carcinoma)

This is how bevacizumab is used

The dose of bevacizumab must be adjusted individually for each patient. A guideline is five to 15 milligrams per kilogram of body weight, which are administered in the form of an infusion every two to three weeks. Depending on tolerance, the infusion takes about 90 minutes.

The infusion must always be given in the presence of qualified personnel.

Bevacizumab is usually combined with other cancer medicines. Bevacizumab ensures that the growth of the tumor is inhibited. Other drugs then help kill the tumor. This results in a very sensible and effective combination in cancer therapy.

Since allergic reactions can often occur during treatment with genetically engineered antibodies, an antiallergic drug is usually given before the infusion is given.

What are the side effects of bevacizumab?

Frequently, i.e. in one to ten percent of those treated, bevacizumab causes side effects such as pain at the infusion site, fatigue and allergic reactions.

Gastrointestinal bleeding, blood clots, high blood pressure, constipation and skin changes may occur less frequently.

What should be considered when taking bevacizumab?

Little data are available on the use of bevacizumab in children and adolescents. Therefore, the attending physician must assess the benefit against the individual risk.

Interactions

When combined with certain drugs, there may be interactions. If bevacizumab is given together with certain cancer drugs (platinum compounds, taxanes), infections and certain changes in the blood count (neutropenia) occur more frequently.

Driving and using machines

There is no evidence that bevacizumab affects the ability to react.

pregnancy and breast feeding period

Medicines containing bevacizumab should not be used in pregnant women. Women of childbearing potential must use contraception during treatment and for up to six months afterwards, as bevacizumab can cause serious harm to the unborn child.

The active substance can possibly pass into breast milk. Therefore, women who are being treated with bevacizumab must stop breastfeeding and refrain from breastfeeding for up to six months after treatment.

How to get medicines with bevacizumab

Medicines with bevacizumab are produced individually for a patient according to the doctor's instructions. That is why they are only available in pharmacies with a prescription from a doctor. They may only be administered by qualified personnel. As a rule, the infusions are delivered directly to the doctor, so that patients do not have to order the medication themselves from the pharmacy.

How long has bevacizumab been known?

The active ingredient bevacizumab has only been approved since 2005, making it a relatively new drug in cancer treatment. However, it is already used frequently and with great success. It is currently being tested whether there may be additional areas of application: Bevacizumab is used, for example, "off-label" - that is (still) without approval - for a certain eye disease (age-related macular degeneration).

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