Bevacizumab or Avastin®
Bevacizumab, also called by its brand name, Avastin, is a tumour-starving cancer treatment drug. It is designed to prevent the growth of new blood vessels that could feed a tumour.
Bevacizumab is effective in treating some forms of cancer. But, it’s not yet clear how effective it is in treating brain tumours. Because of this, it’s not licenced for the treatment of brain tumours in the UK.
But, it is being used in some clinical trials. It’s currently being trialled for high grade gliomas in both adults and children, particularly in combination with chemotherapy and/or radiotherapy.
On this page, we’ll discuss:
- What is Avastin?
- How does Avastin work?
- Does Avastin work for brain tumours?
- Can I have Avastin?
- If I have Avastin…
What is Avastin?
Avastin is the brand name of a drug called bevacizumab. Bevacizumab is a type of cancer treatment called a ‘monoclonal antibody’.
Antibodies are naturally occurring proteins within our bodies that our immune system makes when it detects harmful substances. The antibodies work to remove or kill the harmful substances.
Researchers have learned how to make antibodies that detect specific substances, known as ‘markers’, on the surface of some tumour cells. When many exact copies of that antibody are made, they are called Monoclonal Antibodies (MABs).
How does Avastin work?
Bevacizumab works by attaching itself to markers on the tumour cells’ surface and blocking signals that help the cells to grow or divide.
Bevacizumab is designed to block a protein known as VEGF, which stands for vascular endothelial growth factor. Some of the normal cells in your body make VEGF, but some cancer cells make too much of it.
So, if bevacizumab can block VEGF, it might stop or reduce tumour-feeding cells growing.
This is what sets this drug apart from chemotherapy, for example. While chemotherapy is designed to target the tumour itself, bevacizumab is designed to stop the tumour from growing by blocking its blood supply.
Does Avastin work for brain tumours?
Some early studies initially produced promising results in apparently stopping the growth of glioblastomas. These are glioblastomas (GBMs) that have returned after initial treatment.
This led to accelerated approval of the drug in the USA. However, in Europe it was felt that this shrinking could be due to bevacizumab’s effect of reducing swelling in and around the tumour rather than shrinking the tumour itself. As a result, Europe (including the UK) have not authorised it for treatment of brain tumours.
Newly diagnosed glioblastomas
A significant Avastin trial on newly diagnosed glioblastoma showed no improvement in overall survival.
There was a small improvement in ‘progression-free survival’. This means that symptoms did not worsen. But, the results didn’t reach the target set before the trial.
Other trials have confirmed this trial’s findings.
The evidence currently suggests it may not be suitable as first line use in newly diagnosed patients.
Other brain tumours
Research into whether bevacizumab is helpful in treating other brain tumours is ongoing within clinical trials. These include recurrent grade 2 and 3 gliomas, and grade 3 and 4 non-brainstem gliomas in children.
Can I have Avastin?
It is very unlikely that you will be able to have bevacizumab. This is because it is not licensed in the UK.
If your medical team believes it would benefit you, they may be able to help you to access to the drug via the following routes:
- Independent Funding Request – your clinician makes a request, on your behalf, to your local health body.
- Cancer Drugs Fund (England only) – bevacizumab is only on the list for third line use in low grade gliomas in children.
- Clinical trial- speak to your specialist about trials that may be suitable for you.
- ‘Compassionate use’ or ‘off-label use‘.
- Paying for it yourself.
If your medical team does not think bevacizumab would benefit you, you are entitled to request a second opinion from another health professional. Your GP or your neuro-oncologist can help to arrange this.
If you would like to know more about accessing unlicensed drugs, click the button below.
If I have Avastin
How will I take Avastin or bevacizumab?
You take bevacizumab ‘intravenously’ i.e. in a drip directly into your vein, usually over a series of sessions every two to three weeks. You’ll do this during a day session as an outpatient.
It is sometimes given in combination with chemotherapy or radiotherapy.
What are the common side-effects of bevacizumab?
The most common side-effects of bevacizumab include:
- hypertension (high blood pressure)
- constipation, diarrhoea and abdominal pain
- nosebleeds or rectal bleeding
- dry or inflamed skin
- back pain or headaches.
The most common serious side-effects of bevacizumab include:
- serious bleeding
- wounds that don’t heal
- gastrointestinal perforation (hole in the stomach or intestine).
These side-effects can sometimes be life-threatening. Contact your health care team if you have any signs of side-effects, or any of the following:
- chest pain
- difficulty speaking or moving
- changes in vision
- swelling, warmth or redness in an arm or leg.
Bevacizumab can also affect vaccinations, pregnancy, breast feeding and use of other medicines. So, be sure to tell your healthcare team about your medical status before using bevacizumab.
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