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Bevacizumab Dosage

Medically reviewed on March 6, 2018.

Applies to the following strengths: 25 mg/mL

Usual Adult Dose for Colorectal Cancer

-In combination with bolus-IFL: 5 mg/kg IV every 2 weeks
-In combination with FOLFOX4: 10 mg/kg IV every 2 weeks
-In combination with a fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy regimen in patients who have progressed on a first-line bevacizumab-containing regimen: 5 mg/kg IV every 2 weeks or 7.5 mg/kg IV every 3 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use:
-For first or second line therapy of patients with metastatic carcinoma of the colon or rectum in combination with IV 5-fluorouracil-based chemotherapy
-For second line therapy of patients with metastatic colorectal cancer who have progressed on a first-line bevacizumab-containing regimen, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy

Usual Adult Dose for Non-Small Cell Lung Cancer

In combination with carboplatin and paclitaxel: 15 mg/kg IV every 3 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For first-line therapy of unresectable, locally advanced, recurrent, or metastatic non-squamous non-small cell lung cancer in combination with carboplatin and paclitaxel

Usual Adult Dose for Glioblastoma Multiforme

10 mg/kg every 2 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For glioblastoma with progressive disease in adult patients following prior therapy as a single agent (effectiveness in glioblastoma is based on an improvement in objective response rate; there are no data demonstrating an improvement in disease-related symptoms or increased survival with this drug)

Usual Adult Dose for Renal Cell Carcinoma

In combination with interferon alfa: 10 mg/kg IV every 2 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For metastatic renal cell carcinoma in combination with interferon alfa

Usual Adult Dose for Cervical Cancer

In combination with paclitaxel and cisplatin OR paclitaxel and topotecan: 15 mg/kg IV every 3 weeks

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For persistent, recurrent, or metastatic carcinoma of the cervix in combination with paclitaxel and cisplatin or paclitaxel and topotecan

Usual Adult Dose for Ovarian Cancer

Platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer:
10 mg/kg IV every 2 weeks in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly)
OR
15 mg/kg IV every 3 weeks in combination with topotecan (every 3 weeks)

Platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer:
15 mg/kg IV every 3 weeks in combination with carboplatin and paclitaxel for 6 cycles and up to 8 cycles, followed by continued use of bevacizumab 15 mg/kg IV every 3 weeks as a single agent until disease progression
OR
15 mg/kg IV every 3 weeks in combination with carboplatin and gemcitabine for 6 cycles and up to 10 cycles, followed by continued use of bevacizumab 15 mg/kg IV every 3 weeks as a single agent until disease progression.

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use:
-For platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who received no more than 2 prior chemotherapy regimens in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan
-For platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer either in combination with carboplatin and paclitaxel or in combination with carboplatin and gemcitabine, followed by this drug as a single agent

Usual Adult Dose for Fallopian Tube Cancer

Platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer:
10 mg/kg IV every 2 weeks in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly)
OR
15 mg/kg IV every 3 weeks in combination with topotecan (every 3 weeks)

Platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer:
15 mg/kg IV every 3 weeks in combination with carboplatin and paclitaxel for 6 cycles and up to 8 cycles, followed by continued use of bevacizumab 15 mg/kg IV every 3 weeks as a single agent until disease progression
OR
15 mg/kg IV every 3 weeks in combination with carboplatin and gemcitabine for 6 cycles and up to 10 cycles, followed by continued use of bevacizumab 15 mg/kg IV every 3 weeks as a single agent until disease progression.

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use:
-For platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who received no more than 2 prior chemotherapy regimens in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan
-For platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer either in combination with carboplatin and paclitaxel or in combination with carboplatin and gemcitabine, followed by this drug as a single agent

Usual Adult Dose for Peritoneal Cancer

Platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer:
10 mg/kg IV every 2 weeks in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly)
OR
15 mg/kg IV every 3 weeks in combination with topotecan (every 3 weeks)

Platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer:
15 mg/kg IV every 3 weeks in combination with carboplatin and paclitaxel for 6 cycles and up to 8 cycles, followed by continued use of bevacizumab 15 mg/kg IV every 3 weeks as a single agent until disease progression
OR
15 mg/kg IV every 3 weeks in combination with carboplatin and gemcitabine for 6 cycles and up to 10 cycles, followed by continued use of bevacizumab 15 mg/kg IV every 3 weeks as a single agent until disease progression.

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not initiate therapy until at least 28 days following major surgery. Administer after the surgical incision has fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use:
-For platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who received no more than 2 prior chemotherapy regimens in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan
-For platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer either in combination with carboplatin and paclitaxel or in combination with carboplatin and gemcitabine, followed by this drug as a single agent

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNINGS:
GI PERFORATION:
-GI perforation (sometimes fatal) has been reported in up to 3.2% of patients. Discontinue therapy in patients with GI perforation.
SURGERY AND WOUND HEALING COMPLICATIONS:
-Wound healing and surgical complications (sometimes fatal) have been reported. Discontinue therapy in patients with wound dehiscence. The appropriate interval between termination of therapy and subsequent elective surgery required to reduce the risks of impaired wound healing/wound dehiscence has not been determined. Discontinue at least 28 days prior to elective surgery. Do not reinitiate therapy for at least 28 days after surgery and until the surgical wound is fully healed.
HEMORRHAGE:
-Severe or fatal hemorrhage, including hemoptysis, GI bleeding, CNS hemorrhage, epistaxis, and vaginal bleeding occur up to 5-fold more frequently in patients receiving this drug. Do not initiate therapy in patients with serious hemorrhage or recent hemoptysis.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-The first dose should be infused over 90 minutes following chemotherapy. If it is well tolerated, the second dose may be infused over 60 minutes. If the 60 minute infusion is well tolerated, all subsequent doses may be infused over 30 minutes.
-Do not administer as an IV push or bolus.

General:
-Do not initiate therapy for at least 28 days following major surgery and the surgical incision is fully healed.
-Prepare, administer, and dispose of this drug according to standard protocols for antineoplastic drugs.
-This drug is not formulated for intravitreal use.

Monitoring:
-Hypersensitivity: Infusion-related reactions
-Cardiovascular: Blood pressure monitoring for hypertension
-Renal: Proteinuria
-Common adverse events: Arterial or venous thromboembolic events, GI perforation, fistulae, delayed wound healing, hemorrhage (including tumor-associated hemorrhage), congestive heart failure, neutropenia, osteonecrosis of the jaw, and reversible posterior leukoencephalopathy syndrome.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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