Bevacizumab (Avastin) for Stage IV Cancer
Also known as: Avastin
The first anti-angiogenesis drug approved for cancer, targeting VEGF to starve tumors of their blood supply.
Mechanism of Action
Bevacizumab is a humanized monoclonal antibody that binds VEGF-A, preventing interaction with VEGF receptors (VEGFR-1, VEGFR-2) on endothelial cells. This inhibits tumor angiogenesis, normalizes existing tumor vasculature (improving drug delivery), and reduces vascular permeability. Vessel normalization may enhance chemotherapy and immunotherapy efficacy.
General mechanism: Anti-VEGF monoclonal antibody. Inhibits tumor angiogenesis and normalizes tumor vasculature.
Current Evidence
Extensive clinical data across colorectal, lung, renal, ovarian, cervical, and brain cancers. Combination with chemotherapy improves progression-free survival. In glioblastoma, reduces edema and improves quality of life. Biosimilars now available.
Clinical Status: FDA-approved for multiple cancer types since 2004. Biosimilars available. Standard component of many combination regimens.
Safety Profile
Hypertension, proteinuria, bleeding, wound healing complications. GI perforation risk. Contraindicated pre-surgery.
Key Research Questions
- How does bevacizumab-mediated vascular normalization affect immunotherapy response?
- Can anti-angiogenic therapy be combined with metabolic interventions?
- What biomarkers predict anti-angiogenic sensitivity vs. resistance?