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Synonyms: Avastin® | rhuMAb-VEGF
bevacizumab is an approved drug (FDA (2004), EMA (2005))
Compound class: Antibody
Comment: Vascular endothelial growth factor A inhibitor.
Annotated peptide sequences for this antibody are available from its IMGT/mAb-DB record.
Biosimilars: Amgen's bevacizumab-awwb (Mvasi®) was the first bevacizumab biosimilar to be FDA approved. This and others are listed in the table below.
|No information available.|
|Summary of Clinical Use|
|Used as part of combination therapy for metastatic colorectal cancer and HER2-negative metastatic breast cancer. In August 2014 the US FDA granted additional approval for metastatic cervical cancer. In November 2014, FDA approval was extended to include a combination therapy of bevacizumab plus chemotherapy (paclitaxel, pegylated liposomal doxorubicin or topotecan) for platinum-resistant, recurrent ovarian cancer (based on findings from the Phase 3 AURELIA clinical trial NCT00976911). Additional Phase 2 clinical trial results are provided in . In June 2018, FDA approval was further expanded to include the treatment of epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with carboplatin and paclitaxel, followed by single-agent bevacizumab, in patients with stage III or IV disease, and to be used after initial surgical resection  .
Clinical trials evaluating bevacizumab in combination with the immune checkpoint inhibitors ipilimumab (anti-CTLA4) or nivolumab (anti-PD-1) in advanced solid malignancies are underway (for example NCT01950390- Phase 2 stage III-IV melanoma; NCT01454102- Phase 1 stage IIIB/IV non-small cell lung cancer).
A re-engineered version of bevacizumab with a different glycosylation profile (bevacizumab beta, ABP 215) is in Phase 3 clinical trial for metastatic non-small cell lung cancers (NSCLC), This trial, NCT01966003 is comparing bevacizumab beta vs. the original bevacizumab,
Bevacizumab (Avastin®) is sometimes prescribed 'off-label' as a therapy for wet age-related macular degeneration (AMD), as an alternative to ranibizumab (Lucentis®) and aflibercept (Eylea®).
SARS-CoV-2 and COVID-19: Bevacizumab has been entered into clinical trials in patients with COVID-19, to determine if suppression of vascular permeability will reduce pulmonary edema in severe/critical COVID-19 patients.
|Mechanism Of Action and Pharmacodynamic Effects|
|A recombinant humanized monoclonal IgG1 antibody that binds to and inhibits the biologic activity of human vascular endothelial growth factor (VEGF) which reduces or prevents angiogenesis. The rationale behind anti-VEGF as an anti-angiogenic therapy is described in .|
|Clinical Trial ID||Title||Type||Source||Comment||References|
|NCT00976911||AURELIA: A Study of Avastin (Bevacizumab) Added to Chemotherapy in Patients With Platinum-resistant Ovarian Cancer||Phase 3 Interventional||Hoffmann-La Roche|
|NCT01454102||Study of Nivolumab (BMS-936558) in Combination With Gemcitabine/Cisplatin, Pemetrexed/Cisplatin, Carboplatin/Paclitaxel, Bevacizumab Maintenance, Erlotinib, Ipilimumab or as Monotherapy in Subjects With Stage IIIB/IV Non-small Cell Lung Cancer (NSCLC) (CheckMate 012)||Phase 1 Interventional||Bristol-Myers Squibb|
|NCT01950390||Ipilimumab With or Without Bevacizumab in Treating Patients With Stage III-IV Melanoma That Cannot Be Removed by Surgery||Phase 2 Interventional||National Cancer Institute (NCI)|
|NCT01966003||Efficacy and Safety Study of ABP 215 Compared With Bevacizumab in Patients With Advanced Non-Small Cell Lung Cancer||Phase 3 Interventional||Amgen|
|NCT04275414||Bevacizumab in Severe or Critical Patients With COVID-19 Pneumonia||Phase 2/Phase 3 Interventional||Qilu Hospital of Shandong University||Bevacizumab is being evaluated as a mechanism to suppress vascular permeability and pulmonary edema in patients with severe/critical COVID-19. This anti-VEGF drug is predicted to reduce acute lung injury and acute respiratory distress syndrome (ARDS) in selected patients, and hopefully to reduce respiratory failure and death from COVID-19.|
|NCT04344782||Trial Evaluating Efficacy and Safety of Bevacizumab (Avastin®/Zeribev®) in Patients With COVID-19 Infection, Nested in the Corimmuno-19 Cohort||Phase 2 Interventional||Assistance Publique - Hôpitaux de Paris|
|NCT04305106||Bevacizumab in Severe or Critically Severe Patients With COVID-19 Pneumonia-RCT||N/A Interventional||Qilu Hospital of Shandong University|
For extended ADME data see the following:
Electronic Medicines Compendium (eMC)
European Medicines Agency (EMA)