Bevacizumab

Bevacizumab
Mechanism of action	Binds and inhibits vascular endothelial growth factor (VEGF), a protein critical to tumor angiogenesis.
Dose	For metastatic carcinoma of the colon or rectum, 5 mg/kg or 10 mg/kg IV infusion every 14 days, depending on the regimen being used. For non-squamous, non-small cell lung cancer, the recommended dose is 15 mg/kg as an IV infusion every 3 weeks.
Indications	Used in combination with 5-fluorouracil as first-line and second-line therapy for patients with metastatic carcinoma of the colon or rectum. Used in combination with carboplatin and paclitaxel, is indicated for first line treatment of patients with unresectable, locally advanced, recurrent or metastatic non-squamous, non-small cell lung cancer.
Side Effects	Side effects include asthenia, pain, abdominal pain, headache, hypertension, diarrhea, nausea, vomiting, anorexia, stomatitis, clot formation, constipation, dyspnea, rash, and proteinuria. Serious but less common side effects include GI perforation/wound healing complications and hemorrhage (lung and abdomen). This drug causes a risk of the occurrence of reversible posterior leukoencephalopathy syndrome (RPLS) and should be discontinued in patients who develop RPLS. Risk of nasal septum perforation and non-gastrointestinal fistula formation exists.
Nursing Considerations	Monitor blood pressure every 2–3 weeks during treatment, more frequently if the patient develops hypertension. Therapy should not be started for at least 28 days following surgery. Surgical incision should be fully healed prior to starting therapy. Do not administer or mix with dextrose solutions. Permanently discontinue medication if patient develops GI perforation, wound dehiscence requiring medical intervention, serious bleeding, nephrotic syndrome or hypertensive crisis. Temporarily suspend if evidence of moderate to severe proteinuria and severe hypertension until evaluation and appropriate treatment provided. Administer as a 90-minute infusion following chemotherapy. If the first infusion is well tolerated, the second may be administered over 60 minutes. If that is well tolerated, all subsequent infusions may be over 30 minutes.

Mechanism of action

Binds and inhibits vascular endothelial growth factor (VEGF), a protein critical to tumor angiogenesis.

Dose

For metastatic carcinoma of the colon or rectum, 5 mg/kg or 10 mg/kg IV infusion every 14 days, depending on the regimen being used.

For non-squamous, non-small cell lung cancer, the recommended dose is 15 mg/kg as an IV infusion every 3 weeks.

Indications

Used in combination with 5-fluorouracil as first-line and second-line therapy for patients with metastatic carcinoma of the colon or rectum. Used in combination with carboplatin and paclitaxel, is indicated for first line treatment of patients with unresectable, locally advanced, recurrent or metastatic non-squamous, non-small cell lung cancer.

Side Effects

Side effects include asthenia, pain, abdominal pain, headache, hypertension, diarrhea, nausea, vomiting, anorexia, stomatitis, clot formation, constipation, dyspnea, rash, and proteinuria.

Serious but less common side effects include GI perforation/wound healing complications and hemorrhage (lung and abdomen).

This drug causes a risk of the occurrence of reversible posterior leukoencephalopathy syndrome (RPLS) and should be discontinued in patients who develop RPLS.

Risk of nasal septum perforation and non-gastrointestinal fistula formation exists.

Nursing Considerations

Monitor blood pressure every 2–3 weeks during treatment, more frequently if the patient develops hypertension.

Therapy should not be started for at least 28 days following surgery. Surgical incision should be fully healed prior to starting therapy.

Do not administer or mix with dextrose solutions.

Permanently discontinue medication if patient develops GI perforation, wound dehiscence requiring medical intervention, serious bleeding, nephrotic syndrome or hypertensive crisis.

Temporarily suspend if evidence of moderate to severe proteinuria and severe hypertension until evaluation and appropriate treatment provided.

Administer as a 90-minute infusion following chemotherapy. If the first infusion is well tolerated, the second may be administered over 60 minutes. If that is well tolerated, all subsequent infusions may be over 30 minutes.