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.

Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (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 the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

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).

Adverse Reactions:

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

Generic Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 4)
Appx. price $6641
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.

Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (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 the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

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).

Adverse Reactions:

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

Generic Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 4)
Appx. price $6641
GoodRx

Colorectal and other GI cancers:

Indications for AVASTIN:

Metastatic colorectal carcinoma (mCRC), 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. Limitations of use: not for adjuvant treatment of colon cancer. In combination with atezolizumab for the treatment of unresectable or metastatic hepatocellular carcinoma (HCC) in patients who have not received prior systemic therapy.

Adult:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. mCRC: 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). HCC: 15mg/kg (after administration of atezolizumab 1200mg) every 3 weeks until disease progression or unacceptable toxicity.

Children:

<18yrs: not established.

Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (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 the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

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).

Adverse Reactions:

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

Generic Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 4)
Appx. price $6641
GoodRx

Gynecologic cancers:

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.

Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (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 the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

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).

Adverse Reactions:

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

Generic Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 4)
Appx. price $6641
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.

Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (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 the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

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).

Adverse Reactions:

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

Generic Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Pricing for AVASTIN

4ml of 100mg/4ml vial (Qty: 4)
Appx. price $6641
GoodRx