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 |
HCCIIII | Atezolizumab | 15 mg/kg IV | Every 3 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.[3,14]
#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.
IIII15 mg/kg IV dose evaluated in HCC after IV administration of 1200 mg of atezolizumab on the same day, every 3 weeks until disease progression or unacceptable toxicity.
Recurrent glioblastoma (rGBM)
Avastin is indicated for the treatment of recurrent glioblastoma in adults.
The FDA-approved Prescribing Information addresses the duration of Avastin treatment[1]
Patients should continue treatment until disease progression or unacceptable toxicity.
No dose reductions for Avastin are recommended.
Adverse reaction | Severity | Dosage modification |
---|---|---|
Gastrointestinal Perforation and Fistulae |
|
Discontinue Avastin |
Wound Healing Complications | Any | Withhold Avastin until adequate wound healing. The safety of resumption of Avastin after resolution of wound healing complications has not been established. |
|
Discontinue Avastin | |
Hemorrhage |
|
Discontinue Avastin |
|
Withhold Avastin | |
Thromboembolic Events |
|
Discontinue Avastin |
|
Discontinue Avastin | |
Hypertension |
|
Discontinue Avastin |
|
Withhold Avastin if not controlled with medical management; resume once controlled | |
Posterior Reversible Encephalopathy Syndrome (PRES) | Any | Discontinue Avastin |
Renal Toxicity and Proteinuria |
|
Discontinue Avastin |
|
Withhold Avastin until proteinuria less than 2 grams per 24 hours | |
Infusion-Related Reaction |
|
Discontinue Avastin |
|
Interrupt infusion; resume at a decreased rate of infusion after symptoms resolve | |
|
Decrease infusion rate | |
Congestive Heart Failure | Any | Discontinue Avastin |
Avastin Prescribing Information. Genentech, Inc. 2022.
Avastin Prescribing Information. Genentech, Inc. 2022.
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Data on file. Genentech, Inc.
Data on file. Genentech, Inc.
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MMIT Analysis.
MMIT Analysis.
IQVIA Plantrak Corticosteroid Data.
IQVIA Plantrak Corticosteroid Data.
HLI lives database.
HLI lives database.
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