About Avastin: Dosing

Avastin dosing in approved cancer types

Avastin is administered as a solution for intravenous (IV) infusion at the following doses and schedules[1]:

Tumor type Combination regimen Avastin dose Avastin schedule
MCRC IFL* (First-line Study 2107) 5 mg/kg IV Every 2 weeks
FOLFOX4 (Second-line Study E3200) 10 mg/kg IV Every 2 weeks
Fluoropyrimidine-based chemotherapy in patients who had progressed on a first-line Avastin-containing regimen
(First- through second-line TML study§)
5 mg/kg IV Every 2 weeks
7.5 mg/kg IV Every 3 weeks
NSCLC|| PC 15 mg/kg IV Every 3 weeks
mRCC IFN 10 mg/kg IV Every 2 weeks
CC# Cisplatin/paclitaxel or topotecan/paclitaxel 15 mg/kg IV Every 3 weeks
OC Carboplatin and paclitaxel** 15 mg/kg IV Every 3 weeks
psOC†† Carboplatin and gemcitabine 15 mg/kg IV Every 3 weeks
Carboplatin and paclitaxel 15 mg/kg IV Every 3 weeks
prOC‡‡ Paclitaxel (weekly) 10 mg/kg IV Every 2 weeks
PLD
Topotecan (weekly)
Topotecan (every 3 weeks) 15 mg/kg IV Every 3 weeks
rGBM§§ None (single agent) 10 mg/kg IV Every 2 weeks

*5 mg/kg IV dose evaluated in first-line MCRC in combination with 5-fluorouracil (5-FU)/leucovorin (LV)/irinotecan (IFL).
10 mg/kg IV dose evaluated in second-line, Avastin-naive MCRC patients in combination with 5-FU/LV/oxaliplatin (FOLFOX4).[1,4]
5 mg/kg IV every 2 weeks and 7.5 mg/kg IV every 3 weeks doses evaluated, in combination with fluoropyrimidine and either irinotecan- or oxaliplatin-containing chemotherapy, in MCRC patients who had progressed on a first-line Avastin-containing regimen.
§TML=Treatment through Multiple Lines (first and second line).
||15 mg/kg IV dose evaluated in first-line locally advanced or metastatic non-squamous NSCLC in combination with paclitaxel + carboplatin (PC). Avastin plus PC was given for up to 6 cycles, after which Avastin was continued alone until disease progression or unacceptable toxicity.
10 mg/kg IV dose evaluated in mRCC in combination with interferon alfa (IFN). AVOREN protocol allowed for IFN dose escalation (attaining a dose of 9 million international units [MIU] within the first 2 weeks), reduction, or discontinuation. IFN was discontinued after 52 weeks or earlier.[1,7]
#15 mg/kg IV dose evaluated in CC in combination with cisplatin/paclitaxel or topotecan/paclitaxel. Treatment was given until disease progression or unacceptable toxicity.
**15 mg/kg IV dose evaluated in stage III or IV OC following initial surgical resection in combination with carboplatin and paclitaxel. Avastin plus carboplatin and paclitaxel was given for up to 6 cycles, after which Avastin was continued alone for a total of up to 22 cycles, or until disease progression or unacceptable toxicity.
††15 mg/kg IV dose evaluated in psOC in combination with carboplatin and paclitaxel for 6-8 cycles or carboplatin and gemcitabine for 6-10 cycles after which Avastin was continued alone until disease progression.
‡‡10 mg/kg IV dose evaluated in prOC in combination with weekly paclitaxel, PLD (pegylated liposomal doxorubicin), or weekly topotecan, and 15 mg/kg IV dose evaluated in combination with topotecan administered every 3 weeks. Treatment was given until disease progression or unacceptable toxicity.
§§10 mg/kg IV dose evaluated as a single agent for rGBM that has progressed following prior therapy.

Recurrent glioblastoma (GBM)
Avastin is indicated for the treatment of recurrent glioblastoma in adults.

Pregnancy warning

  • Based on the mechanism of action and animal studies, Avastin may cause fetal harm
  • Advise female patients that Avastin may cause fetal harm, and to inform their healthcare provider of a known or suspected pregnancy
  • Advise females of reproductive potential to use effective contraception during treatment with Avastin and for 6 months after the last dose of Avastin
  • Advise nursing women not to breastfeed during treatment with Avastin and for 6 months following their last dose of treatment
  • Avastin may impair fertility

Duration of Avastin treatment

The FDA-approved Prescribing Information addresses the duration of Avastin treatment[1]
Patients should continue treatment until disease progression or unacceptable toxicity.

Important treatment considerations—Dose modifications

No dose reductions for Avastin are recommended.

Dose Modifications for Adverse Reactions

Adverse reaction Severity Dose modification
Gastrointestinal Perforation and Fistulae
  • Gastrointestinal perforation, any grade
  • Tracheoesophageal fistula, any grade
  • Fistula, Grade 4
  • Fistula formation involving any internal organ
Discontinue Avastin
Wound Healing Complications
  • Wound healing complications requiring medical intervention
  • Necrotizing fasciitis
Discontinue Avastin
Hemorrhage
  • Grade 3 or 4
Discontinue Avastin
  • Recent history of hemoptysis of 1/2 teaspoon (2.5 mL) or more
Withhold Avastin
Thromboembolic Events
  • Arterial thromboembolism, severe
Discontinue Avastin
  • Venous thromboembolism, Grade 4
Discontinue Avastin
Hypertension
  • Hypertensive crisis
  • Hypertensive encephalopathy
Discontinue Avastin
  • Hypertension, severe
Withhold Avastin if not controlled with medical management; resume once controlled
Posterior Reversible Encephalopathy Syndrome (PRES) Any Discontinue Avastin
Renal Toxicity and Proteinuria
  • Nephrotic syndrome
Discontinue Avastin
  • Proteinuria greater than or equal to 2 grams per 24 hours in absence of nephrotic syndrome
Withhold Avastin until proteinuria less than 2 grams per 24 hours
Infusion Reaction
  • Severe infusion reaction
Discontinue Avastin
  • Clinically significant
Interrupt infusion; resume at a decreased rate of infusion after symptoms resolve
  • Mild, clinically insignificant
Decrease infusion rate
Congestive Heart Failure Any Discontinue Avastin

View dose and duration information by specific cancer type