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Bevacizumab

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-BEVACIZUMAB
TypeDrug
Aliases
Alymsys (biosimilar)AvastinMvasi (biosimilar)Vegzelma (biosimilar)Zirabev (biosimilar)Бевацизумаб
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-CERVICAL DIS-CRC DIS-GBM DIS-HCC DIS-OVARIAN
SourcesSRC-NCCN-COLON-2025 SRC-NCCN-HCC-2025

Drug Facts

ClassAnti-VEGF-A humanized IgG1 monoclonal antibody (anti-angiogenic)
MechanismRecombinant humanized IgG1 monoclonal antibody binding all isoforms of vascular endothelial growth factor A (VEGF-A) in plasma and extracellular space, preventing VEGF-A from engaging VEGFR-1 (Flt-1) and VEGFR-2 (KDR) on vascular endothelium. Net effects: inhibition of tumor angiogenesis, regression of existing tumor microvasculature, and transient vessel normalization improving drug delivery. Adds approximately 2-4 months PFS in metastatic CRC when added to FOLFOX/FOLFIRI; combined with atezolizumab in 1L unresectable HCC (IMbrave150) and with chemo in NSCLC, ovarian, cervical. Class effects (HTN, proteinuria, bleeding, perforation) derive from systemic VEGF blockade.
Typical dosingCRC metastatic with FOLFOX/FOLFIRI: 5 mg/kg IV q14d. CRC metastatic with CAPOX: 7.5 mg/kg IV q21d. NSCLC (with carbo/paclitaxel): 15 mg/kg IV q21d × 6 cycles, then maintenance. Ovarian (1L with carbo/paclitaxel): 15 mg/kg IV q21d × 6 cycles + 15 mo maintenance. Cervical: 15 mg/kg IV q21d. Glioblastoma: 10 mg/kg IV q14d. HCC (with atezolizumab): 15 mg/kg IV q21d. Hold ≥28 days pre-elective surgery; resume ≥28 days post-op with full wound healing.
Ukraine registeredTrue
NSZU reimbursedTrue
Ukraine last verified2026-04-27

Warnings

Notes

HCC IMbrave150 prerequisites: pre-treatment EGD to assess varices; high-risk varices need ligation/banding before atezo+bev. Hold ≥28 days pre-elective surgery; resume ≥28 days post-op with full wound healing. Discontinue permanently for: GI perforation, tracheoesophageal fistula, any Grade 4 fistula, any Grade 4 bleeding event, severe arterial thromboembolic event, hypertensive crisis, nephrotic syndrome, PRES. Biosimilars (Mvasi, Zirabev, Alymsys, Vegzelma) clinically interchangeable per FDA / EMA.

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