The drug "Avastin" is considered an antitumor agent, which refers to monoclonal antibodies. During the use of the drug, there is a decrease in the metastatic progression of the pathology and microvascular permeability in all kinds of malignant neoplasms, especially concerning the mammary gland in women, the colon, as well as the pancreas and prostate glands.
The composition of the drug
Avastin is available in the form of a concentrate, which is intended to prepare a solution for infusion, which may be colorless or with a subtle brownish tint.
The main substance of the drug is bevacizumab. This product is available in packs of 100 mg, where 4 ml of the active substance, and 400 mg / 16 ml.
pharmachologic effect
Avastin is a drug against tumors that slows down the formation of new vessels supplying nutrients and oxygen to the tissues of the neoplasm, and thereby allows us to transfer the malignant tumor from the aggressive stage to the chronic one. Avastin (reviews of patients and doctors - confirmation of this) has an overwhelming effect on the metastases of various malignant neoplasms.
For this tool, it is typical to spread throughout the tissues in a minimal amount, in addition, it is eliminated from the body for a sufficiently long time, which allows you to maintain the necessary amount of the main component of the drug, entering it strictly according to the instructions - once every 14-20 days. The drug is not excreted through the liver or kidneys, but through all cells of the body for 18 days in men, and in women - 20.
But is Avastin so good? Patient reviews say that this is a very effective drug if combined with chemotherapy for various types of cancer. This tool significantly increases the survival period in all groups of patients, while the progression of the disease does not occur.
Avastin: indications for use
This drug is widely used in the treatment of cancer. Doctors prescribe it:
- With metastatic colorectal cancer. The drug is recommended to be used in conjunction with chemotherapy based on "Fluoropyrimidine".
- With metastatic breast cancer. It is used as the first line of treatment in conjunction with Paclitaxel.
- With inoperable, accompanied by the presence of a large number of metastases or non-planar, non-small cell lung cancer - as the first line of treatment in combination with chemotherapy based on platinum drugs.
- In case of progressive or metastatic cancer affecting the kidney cells - as a means for primary therapy together with Interferon alfa-2a.
- In case of glioblastoma together with radiation therapy and Temozolomide in patients who have just been diagnosed, in monotherapy or together with Irinotecan in patients with recurrence of glioblastoma or with progression of cancer.
- Patients who have been diagnosed with malignant female genital organs and with primary peritoneal cancer. In this case, it is recommended to prescribe the drug "Avastin" as the first therapeutic therapy in conjunction with "Carboplatin" and "Paclitaxel."
In addition, the drug is prescribed in conjunction with “Carboplatin” and “Gemcitabine” for a progressive disease or for platinum-sensitive patients with cancer of the female genital organs or peritoneum who have not previously been treated with this drug or another kind of VEGF inhibitor.
How to enter Avastin?
Avastin (reviews of patients and doctors confirm this) is a good drug, but it must be administered correctly, and only under the supervision of a doctor. It is strictly forbidden to enter the stream - only intravenously, and then as slowly as possible. The calculation is 5 mg per 1 kg of body weight once every two weeks.
The required amount of concentrate is diluted in 100 ml of 0.9% sodium chloride. The first dose is recommended to be administered one and a half hours after chemotherapy, later the Avastin injection is given before or after the procedure. If the patient received the first injection of the drug without complications, then it can be administered further within an hour, and all subsequent injections can be administered within half an hour, but only if the second injection was well tolerated.
It is not recommended to reduce the dose of the drug even in the presence of undesirable effects, if necessary, the treatment is suspended or stopped.
If a patient has metastatic colorectal cancer, the initially recommended dose is 5 mg per kg of body weight once every 14 days or 7.5 mg / kg, but every 21 days. If the second line of therapy, then the dose is increased by 2 times.
If a woman is diagnosed with breast cancer, in this case, as a first injection, it is recommended to calculate the drug at 10 mg / kg and give injections every two weeks. Or in three, but in this case 15 mg per kg of body weight is taken.
If there are signs of progression of the pathology, treatment is stopped.
With a widespread inoperable, metastatic or recurrent nonplanar or non-small cell cancer in the lung, treatment is carried out together with chemotherapy with Pt drugs (no more than 6 cycles), and then the drug is used as monotherapy.
If signs of cancer progression appear, stop administering Avastin. The instructions for use read: if there is no progression, then the calculation is 7.5 mg / kg every 14 days or the dose is doubled and administered once every three weeks in addition to Cisplatin or Carboplatin.
With renal cell carcinoma, the dose should be no more than 10 mg / kg once every 15 days. If there are signs of disease progression, then treatment is stopped.
Elderly people do not need to adjust the dose.
Avastin: overdose
An overdose of the drug occurs most often if a large dose is prescribed to the patient - 20 mg per kg of patient’s body weight once every 14 days.
In this case, migraine attacks may appear in a rather complicated form, in addition, there is an increase in the undesirable effects described below. There is no particular antidote; only symptomatic therapy is used.
Avastin: side effects
Avastin is a very good preparation; in most cases it helps to slow the progression of a serious disease, but very often undesirable manifestations are observed in patients. In rare cases, they can be quite serious:
- Perforation of the stomach and intestines.
- Internal bleeding.
- Arterial thromboembolism.
- Blood pressure rises and proteinuria develops. Most likely, this is a consequence of the dose dependence of the patient.
In addition, in patients who have been prescribed Avastin, side effects are manifested by other symptoms:
- deep vein thrombosis, a complex form of heart failure, supraventricular tachycardia, bleeding;
- leukopenia, neutropenia, low hemoglobin, thrombocytopenia;
- discomfort in the peritoneum, indigestion, blood in the stool, an infectious rash in the mouth, bleeding gums, bowel obstruction;
- nosebleeds, lack of oxygen, pulmonary thromboembolism;
- dry skin, dermatitis, change in skin tone;
- loss of taste, a sharp decrease in body weight, syncope, migraine, stroke, drowsiness;
- visual impairment;
- pain in the place where the drug is administered;
- bleeding from the uterus, urinary tract infections, a feeling of rapid fatigue, dehydration.
Contraindications
Does Avastin suit everyone? Patient reviews say that this is an excellent drug, but still it also has contraindications for use, and before starting treatment, the doctor should tell about them. The drug can not be prescribed in the following cases:
- if there is a special intolerance to the main active substance;
- there are infectious diseases of the eyes and periocular region;
- intraocular inflammatory processes take place;
- age up to 18 years;
- pregnancy and lactation.
In addition, if the patient is likely to develop a stroke, then an Avastin injection is given only after the patient has been carefully examined and come to the conclusion that the drug will be beneficial.
special instructions
Only a doctor who has experience in performing intraocular injections should conduct drug treatment.
After the drug has been introduced, for some time it is not recommended to drive a car and perform work related to mechanisms, and all because transient visual impairments can develop.
Avastin (the manufacturer indicates this in the instructions) should only be stored in the refrigerator, and in no case should it be frozen. It is released only by prescription.
How does Avastin interact with other drugs?
The drug "Avastin" is incompatible with dextrose solutions. Also, the drug can increase the risk of developing negative reactions if taken together with such drugs:
- "Sunitinib malate" - the development of microangiopathic hemolytic anemia may occur;
- platinum and taxanes - the development of complications of infectious pathologies, severe neutropenia is possible, the risk of a fatal outcome increases;
- "Panitumumab" and "Cetuximab" - increases the toxic effect of drugs and leads to death.
Avastin in ophthalmology
More recently, the press reported that the drug Avastin is used by ophthalmologists to treat eye diseases and gives very good results. But is it? What does the manufacturer say about this? Can this remedy not only stop the growth of the tumor, but also cure diseases of the organs of vision?
Yes, in fact there is information that some patients, having heard about the benefit of the drug for the eyes, decided and made an Avastin injection into the vitreous, but the results were deplorable. The drug did not bring any cure to them, on the contrary, it led to the fact that people were simply blinded. The Rosh company has repeatedly emphasized that Avastin cannot be used in ophthalmology, its purpose is different.
The drug is designed to reduce the growth rate of blood vessels that feed the malignant neoplasm, thereby reducing the intensity of tumor development. That is why, before starting therapy and listening to unsubstantiated recommendations, it is better to consult a doctor.
Avastin: analogues
As for whether there are substitutes that would have the same basic substance in their composition, Avastin does not have them. There are analogs to the mechanism of action, and they also give good results in slowing the growth of blood vessels and the development of cancerous tumors. These include:
- Arzerru.
- Campas.
- Rituximab.
- MabThera et al.
But you must remember that the doctor must choose an analogue.
Avastin: reviews of patients and doctors
"Avastin" (instructions for use confirms this) is the only drug that contains bevacizumab, helps to slow the growth of blood vessels that feed the tumor and thereby slow the progression of the disease. Most of the doctors who observed the dynamics of the disease in a particular patient say that after a couple of injections, the growth of the tumor is noticeable, the main thing is to take the drug correctly and not combine it with drugs, which in combination can cause serious harm to the patient.
Summing up, we can say for sure that Avastin (manufacturer - F. Hoffmann-La Roche) is an excellent one that helps extend the life of patients with cancerous tumors. But it’s only necessary to apply it under the strict supervision of a doctor, otherwise the consequences can be irreversible and end sadly.