#高警訊藥品

Colorectal cancer(Metastatic): 轉移性大腸直腸癌
First- or second-line treatment in combination with (1) fluorouracil-based chemotherapy (2) fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy
Glioblastoma(Recurrent): 神經膠母細胞瘤
Ovarian (epithelial), fallopian tube, or primary peritoneal cancer: 卵巢上皮細胞、輸卵管或原發性腹膜癌
1. Stage III or IV disease: following initial surgical resection (in combination with carboplatin and paclitaxel, followed by single-agent bevacizumab)
2. For patients who received no more than 2 prior chemotherapy regimens, in combination with (1) paclitaxel, doxorubicin [liposomal], or topotecan (2) carboplatin and paclitaxel or with carboplatin and gemcitabine
Non-small cell lung cancer, nonsquamous(NSCLC):非鱗狀非小細胞肺癌
First-line treatment in combination with carboplatin and paclitaxel
Cervical cancer(persistent/recurrent/metastatic): 子宮頸癌
In combination with paclitaxel and either cisplatin or topotecan

Vascular Endothelial Growth Factor (VEGF) Inhibitor, Monoclonal Antibody (Antineoplastic Agent)
Bevacizumab, a recombinant humanized monoclonal IgG1 antibody, binds to vascular endothelial growth factor (VEGF) and inhibits the interaction of VEGF to Flt1 and KDR receptors on the surface of endothelial cells. In the process, it prevents the proliferation of endothelial cells and formation of new blood vessels, thereby inhibiting tumour growth.

Volume of distribution: 2.66 L(female); 3.25 L(male)
Elimination half life: approximately 20 days (11-50 days)

1. Hypersensitivity to Avastin or any components of the product, Chinese hamster ovary cell products or other recombinant human or humanised antibodies
2. Patients with untreated Central Nervous System (CNS) metastases
3. Pregnancy

C; limited information

Due to the potential for serious adverse reactions in the breastfed infant, the manufacturer does not recommend breastfeeding during treatment and for 6 months following the last dose of bevacizumab.

Common
asthenia, dizziness, headache, abdominal pain, constipation, loss of appetite, stomatitis, alopecia, hypertension and proteinuria(dose-dependent)
Serious
gastrointestinal perforations, hemorrhage, aterial thromboembolism

Dosage:
1. Cervical cancer (persistent/recurrent/metastatic): 15 mg/kg every 3 weeks (with paclitaxel and either cisplatin or topotecan)
2. Colorectal cancer (metastatic): 5 mg/kg every 2 weeks (with bolus-IFL) or 10 mg/kg every 2 weeks (with FOLFOX4)
3. Glioblastoma (recurrent): 10 mg/kg every 2 weeks as a single agent
4. Hepatocellular carcinoma (unresectable/metastatic): 15 mg/kg once every 3 weeks (with atezolizumab on the same day)
5. NSCLC (nonsquamous, first-line therapy): 15 mg/kg every 3 weeks (with carboplatin and paclitaxel) for 6 cycles
6. Renal cell cancer (metastatic): 10 mg/kg every 2 weeks (with interferon alfa)
Administration:
1. The initial dose should be IV over 90 minutes, if the first infusion is well tolerated, the infusion time may be shorted to 60 minutes and then 30 minutes.
2. Withdraw the necessary amount of Avastin and dilute in a total volume of 100 ml of 0.9% NaCl.

Prior to treatment:
There are no dosage adjustments provided in the manufacturer's labeling.
During treatment:
1. Nephrotic syndrome: Discontinue bevacizumab
2. Proteinuria ≥2 g/24 hours in the absence of nephrotic syndrome: Withhold bevacizumab until proteinuria <2 g/24 hours

There are no dosage adjustments provided in the manufacturer's labeling.

1. Store at 2-8℃ and protected from light. Do not shake!
2. The diluted Avastin solutions for infusion may be stored at 2-8℃ for up to 8 hrs