Avastin is a widely-used, important first-line drug for colorectal cancer and lung cancer. The following lists key aspects of the drug.

Chemical/Biological Nature: Avastin (bevacizumab, rhuMAb-VEGF) is a recombinant humanized monoclonal antibody drug. Only the complementarity-determining regions (CDR) of the antibody are of mouse origin since the antibody was originally produced in mice. In order to reduce the antigenicity of the antibody to patients, all other regions of the antibody are of human origin. CDRs of an antibody make physical contact with the specific antigen and determine the antibody’s specificity.

Maker: Genentech

Diseases Treated: Metastatic colorectal cancer — approved on February 26, 2004; unresectable non-squamous, non-small cell lung cancer (NSCLC) — approved on October 11, 2006.

Target of the Drug: VEGF (vascular endothelial growth factor)

Mechanism of Drug Action: Avastin binds to VEGF and “neutralizes” it so that it cannot bind to its natural receptor. The molecular events following the binding of VEGF to its receptor are important for angiogenesis (new blood vessel formation). Avastin inhibits angiogenesis including that in the tumor.

Efficacy and Benefits: For metastatic colorectal cancer, the combination of Avastin and chemoagents added an overall survival benefit of 4.7 months compared to chemoagents alone.

For unresectable non-squamous, non-small cell lung cancer (NSCLC), the combination of Avastin and chemoagents added an overall benefit of 2 months compared to chemoagents alone.

Quotation:“Since the pivotal trial results were presented last year, I have had the privilege of meeting several patients who have received treatment with Avastin, and this has been the most rewarding part of watching a scientific theory progress from the lab to the clinic.” — Dr. Napoleone Ferrara, a staff scientist at Genentech where he identified the VEGF gene in 1989.

Major Side Effects: Avastin has a number of adverse effects. The three major ones are gastrointestinal perforations (incidence rate: 0.9-2.4%), wound healing complications (incidence rate: 15% in patients who had surgery within 60 days of receiving the drug), and hemorrhage (incidence rate: 2.3% in patients with NSCLC and 31% in patients with squamous lung cancer). All these three are in the “black box” of the drug labeling.

[Originally written for a company's weekly newsletter. With permission.]