Bevacizumab

What Is Bevacizumab?

Bevacizumab is cancer fighting drug that is sometimes classified as a chemotherapy drug. It is an antiangiogenic agent, meaning that it stops blood vessel formation. This stops the supply of oxygen and nutrients to tumors to slow their growth and spread.

Doctors may inject it or give it through an intravenous drip, a process that can take a few hours. Patients generally need the drug once every three weeks. In 2021, researchers studied how well bevacizumab worked with atezolizumab for mesothelioma patients. After one year, 61% of these patients had no further signs of disease and 85% were still alive.

Researchers tested a drug called bevacizumab (Avastin) on some people with mesothelioma. They combined it with cisplatin and pemetrexed (Alimta). In a study done in France in 2016, the people taking all three drugs lived an average of 18.8 months. This compared to 16.1 months for those who only took chemotherapy alone.

In early clinical trials, bevacizumab (Avastin) helped some mesothelioma patients live longer when combined with chemotherapy drugs cisplatin and pemetrexed (Alimta). In a 2016 phase III clinical trial in France, patients taking a combination of the three drugs survived an average of 18.8 months, compared to 16.1 months for patients only receiving cisplatin and pemetrexed.

Bevacizumab has rare but serious side effects. The phase III clinical trial showed that most of these were not too difficult to deal with.

How Does Bevacizumab Work?

Bevacizumab works differently than chemotherapy. It stops tumors from getting oxygen and nutrients. It inhibits angiogenesis, which is the growth of blood vessels within the tumor.

When angiogenesis happens, it helps the mesothelioma cells in the body to grow and spread. But if there is no angiogenesis, the cancer cells don’t get enough of what they need to survive and eventually die off.

Bevacizumab can stop mesothelioma from spreading and kills cancer cells that are already present.

It is used in combination with other chemotherapy drugs such as a cisplatin-based chemotherapy regimen. Some clinicians have also combined bevacizumab with a second-line chemotherapeutic agent called gemcitabine.

Bevacizumab works to stop angiogenesis while other drugs have a direct toxic effect on cancer cells. Doctors worry that taking this medicine in combination with others may cause more side effects than usual.

Side Effects of Bevacizumab

Bevacizumab may cause dizziness, dry mouth, fatigue, heartburn and loss of appetite. In rare cases, it may cause severe side effects such as blood clots in the lungs, hemorrhaging, holes in the stomach and low white blood cell count. These potentially deadly complications are most common when it is used in conjunction with a chemotherapy drug.

A study of clinical trial results revealed that patients treated with bevacizumab and chemotherapy are 1.5 times more likely to die because of treatment complications than patients treated with chemotherapy alone.

Results of Bevacizumab Studies

A 2008 study tested the effects of bevacizumab with chemotherapy in 24 mesothelioma patients. They previously underwent other treatments with no positive results.

The combination was successful in slowing disease progression in half of patients. Overall, patients lived a median of 5.8 months after being treated with the drug. Researchers reported that it was well-tolerated and warranted further study.

In a case study the following year, a mesothelioma patient underwent treatment with bevacizumab and gemcitabine after other treatments had failed to shrink his tumor or control his symptoms. The combination helped prevent fluid buildup and pain, leading to a better quality of life.

This finding suggests that bevacizumab may aid in palliative, symptom-reducing care in addition to potentially curative, life-extending treatment.