Select therapeutic use:

Bladder, kidney, and other urologic cancers:

Indications for AVASTIN:

Metastatic renal cell carcinoma (mRCC) in combination with interferon alfa.

Adult:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 10mg/kg every 2 weeks with interferon alfa.

Children:

<18yrs: not established.

Boxed Warning:

Gastrointestinal perforations (GI). Surgery and wound healing complications. Hemorrhage.

Warnings/Precautions:

Risk of GI perforations, surgery and wound healing complications, and hemorrhage. Do not start therapy before or for at least 28 days after surgery; allow surgical incisions to completely heal (see full labeling). Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Permanently discontinue if GI perforation, tracheoesophageal fistula, any grade 4 fistula, or grade 4 venous thromboembolic event. Discontinue if fistula involving internal organ, wound healing complications, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event (ATE), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, or severe infusion reaction occurs; suspend therapy if severe hypertension or moderate-to-severe proteinuria (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after last dose. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Vascular endothelial growth factor (VEGF) inhibitor.

Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use); discontinue if CHF develops.

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound dehiscence/impaired healing, necrotizing fasciitis (discontinue if occurs), hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion reactions, ovarian failure, neutropenia, infection.

Generic Availability:

NO

How Supplied:

Single-use vial (4mL, 16mL)—1

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 6)
Appx. price $4739
GoodRx

CNS cancers:

Indications for AVASTIN:

Recurrent gliobastoma in adults.

Adult:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 10mg/kg every 2 weeks.

Children:

<18yrs: not established.

Boxed Warning:

Gastrointestinal perforations (GI). Surgery and wound healing complications. Hemorrhage.

Warnings/Precautions:

Risk of GI perforations, surgery and wound healing complications, and hemorrhage. Do not start therapy before or for at least 28 days after surgery; allow surgical incisions to completely heal (see full labeling). Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Permanently discontinue if GI perforation, tracheoesophageal fistula, any grade 4 fistula, or grade 4 venous thromboembolic event. Discontinue if fistula involving internal organ, wound healing complications, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event (ATE), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, or severe infusion reaction occurs; suspend therapy if severe hypertension or moderate-to-severe proteinuria (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after last dose. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Vascular endothelial growth factor (VEGF) inhibitor.

Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use); discontinue if CHF develops.

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound dehiscence/impaired healing, necrotizing fasciitis (discontinue if occurs), hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion reactions, ovarian failure, neutropenia, infection.

Generic Availability:

NO

How Supplied:

Single-use vial (4mL, 16mL)—1

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 6)
Appx. price $4739
GoodRx

Colorectal and other GI cancers:

Indications for AVASTIN:

Metastatic colorectal carcinoma, in combination with 5-FU-based chemotherapy for first- or second-line treatment; or in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based therapy for second-line treatment in patients who have progressed on a first-line Avastin-containing regimen. Limitation of use: not for adjuvant treatment of colon cancer.

Adult:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 5mg/kg (when used with bolus-IFL) or 10mg/kg (when used with FOLFOX-4) once every 2 weeks until disease progression detected; 5mg/kg every 2 weeks or 7.5mg/kg every 3 weeks (when used with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based therapy).

Children:

<18yrs: not established.

Boxed Warning:

Gastrointestinal perforations (GI). Surgery and wound healing complications. Hemorrhage.

Warnings/Precautions:

Risk of GI perforations, surgery and wound healing complications, and hemorrhage. Do not start therapy before or for at least 28 days after surgery; allow surgical incisions to completely heal (see full labeling). Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Permanently discontinue if GI perforation, tracheoesophageal fistula, any grade 4 fistula, or grade 4 venous thromboembolic event. Discontinue if fistula involving internal organ, wound healing complications, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event (ATE), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, or severe infusion reaction occurs; suspend therapy if severe hypertension or moderate-to-severe proteinuria (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after last dose. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Vascular endothelial growth factor (VEGF) inhibitor.

Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use); discontinue if CHF develops.

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound dehiscence/impaired healing, necrotizing fasciitis (discontinue if occurs), hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion reactions, ovarian failure, neutropenia, infection.

Generic Availability:

NO

How Supplied:

Single-use vial (4mL, 16mL)—1

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 6)
Appx. price $4739
GoodRx

Gynecologic cancers:

Recent Updates:

Approved for treating ovarian cancer.

Indications for AVASTIN:

Persistent, recurrent, or metastatic cervical cancer in combination with paclitaxel/cisplatin, or paclitaxel/topotecan. Recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer (platinum-resistant): in combination with paclitaxel, pegylated liposomal doxorubicin or topotecan in patients who received no more than 2 prior chemotherapy regimens; (platinum-sensitive): in combination with carboplatin/paclitaxel or carboplatin/gemcitabine, followed by Avastin as a single agent. Stage III or IV epithelial ovarian, fallopian tube or primary peritoneal cancer after initial surgical resection, in combination with carboplatin/paclitaxel, followed by Avastin as a single agent.

Adult:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. Cervical cancer: 15mg/kg every 3 weeks with either paclitaxel/cisplatin, or paclitaxel/topotecan. Recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer (platinum-resistant): 10mg/kg every 2 weeks with either paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly); or, 15mg/kg every 3 weeks with topotecan (every 3 weeks); (platinum-sensitive): 15mg/kg every 3 weeks with carboplatin/paclitaxel for 6 cycles and up to 8 cycles or carboplatin/gemcitabine for 6 cycles and up to 10 cycles; followed by Avastin 15mg/kg every 3 weeks as a single agent until disease progression. Stage III/IV ovarian, fallopian tube or peritoneal cancer: 15mg/kg every 3 weeks with carboplatin/paclitaxel for up to 6 cycles; followed by Avastin 15mg/kg every 3 weeks as a single agent, for a total of up to 22 cycles or until disease progression, whichever occurs first.

Children:

<18yrs: not established.

Boxed Warning:

Gastrointestinal perforations (GI). Surgery and wound healing complications. Hemorrhage.

Warnings/Precautions:

Risk of GI perforations, surgery and wound healing complications, and hemorrhage. Do not start therapy before or for at least 28 days after surgery; allow surgical incisions to completely heal (see full labeling). Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Permanently discontinue if GI perforation, tracheoesophageal fistula, any grade 4 fistula, or grade 4 venous thromboembolic event. Discontinue if fistula involving internal organ, wound healing complications, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event (ATE), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, or severe infusion reaction occurs; suspend therapy if severe hypertension or moderate-to-severe proteinuria (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after last dose. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Vascular endothelial growth factor (VEGF) inhibitor.

Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use); discontinue if CHF develops.

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound dehiscence/impaired healing, necrotizing fasciitis (discontinue if occurs), hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion reactions, ovarian failure, neutropenia, infection.

Generic Availability:

NO

How Supplied:

Single-use vial (4mL, 16mL)—1

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 6)
Appx. price $4739
GoodRx

Respiratory and thoracic cancers:

Indications for AVASTIN:

First-line treatment of unresectable, locally advanced, recurrent or metastatic non-squamous, non-small cell lung cancer (NSCLC), in combination with carboplatin and paclitaxel.

Adult:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 15mg/kg every 3 weeks with carboplatin/paclitaxel.

Children:

<18yrs: not established.

Boxed Warning:

Gastrointestinal perforations (GI). Surgery and wound healing complications. Hemorrhage.

Warnings/Precautions:

Risk of GI perforations, surgery and wound healing complications, and hemorrhage. Do not start therapy before or for at least 28 days after surgery; allow surgical incisions to completely heal (see full labeling). Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Permanently discontinue if GI perforation, tracheoesophageal fistula, any grade 4 fistula, or grade 4 venous thromboembolic event. Discontinue if fistula involving internal organ, wound healing complications, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event (ATE), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, or severe infusion reaction occurs; suspend therapy if severe hypertension or moderate-to-severe proteinuria (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after last dose. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Vascular endothelial growth factor (VEGF) inhibitor.

Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use); discontinue if CHF develops.

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound dehiscence/impaired healing, necrotizing fasciitis (discontinue if occurs), hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion reactions, ovarian failure, neutropenia, infection.

Generic Availability:

NO

How Supplied:

Single-use vial (4mL, 16mL)—1

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 6)
Appx. price $4739
GoodRx