Overview: Bevacizumab is a humanized monoclonal antibody that targets vascular endothelial growth factor A (VEGF‑A) to inhibit new blood vessel formation. Marketed under the name Avastin, it is administered by intravenous infusion and is used to limit tumour vascular growth and associated progression.
Mechanism and characteristics
Bevacizumab binds circulating VEGF‑A, preventing it from activating VEGF receptors on endothelial cells. This anti‑angiogenic effect can slow tumour growth, reduce vascular permeability, and alter the tumour microenvironment. It is given systemically, usually in combination with chemotherapy, and dosing is adjusted by body weight and treatment regimen.
Clinical uses
Regulatory approvals and clinical practice include treatment of several solid tumours, often combined with cytotoxic agents. Examples include:
- Colorectal and non‑squamous non‑small cell lung cancers when used with chemotherapy.
- Renal cell carcinoma, often in combination approaches; see metastatic renal cell carcinoma.
- It has been used in breast cancer settings; see discussions at metastatic breast cancer.
- In some jurisdictions it has approval or use for glioblastoma; see glioblastoma multiforme.
- Off‑label, small‑volume intravitreal injections are widely used in ophthalmology to treat neovascular age‑related macular degeneration and diabetic macular edema.
Adverse effects and precautions
Common and important risks include hypertension, bleeding, arterial and venous thromboembolism, impaired wound healing, proteinuria and rare gastrointestinal perforation. Because of wound‑healing concerns, clinicians typically delay elective surgery for a defined interval before and after therapy. It is contraindicated in pregnancy because angiogenesis blockade can harm fetal development.
History and notable facts
Bevacizumab was among the first approved targeted anti‑angiogenic agents and changed treatment strategies for several cancers. Its high cost and variable benefit in some settings generated debate and regulatory review in different countries. It remains a cornerstone anti‑VEGF agent with both oncologic and ophthalmologic impact.