Bevacizumab
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-BEVACIZUMAB |
|---|---|
| Тип | Препарат |
| Синоніми | Alymsys (biosimilar)AvastinMvasi (biosimilar)Vegzelma (biosimilar)Zirabev (biosimilar)Бевацизумаб |
| Статус | переглянуто 2026-04-26 | очікує клінічного підпису |
| Хвороби | DIS-CERVICAL DIS-CRC DIS-GBM DIS-HCC DIS-OVARIAN |
| Джерела | SRC-NCCN-COLON-2025 SRC-NCCN-HCC-2025 |
Дані про препарат
| Клас | Anti-VEGF-A humanized IgG1 monoclonal antibody (anti-angiogenic) |
|---|---|
| Механізм дії | Recombinant 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. |
| Типове дозування | CRC 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. |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Застереження
- GI perforation (incidence 1-3% in CRC; higher in ovarian, cervical, GBM)
- Surgery / wound healing complications (hold ≥28 days pre-op; restart ≥28 days post-op only with full healing)
- Hemorrhage (severe pulmonary, GI, CNS — including fatal hemoptysis)
Нотатки
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.
Де використовується
Regimens
REG-5FU-LV-BEV-CKD-MODIFIED- 5-FU + Leucovorin + Bevacizumab (sLV5FU2-Bev, CRC severe CKD CrCl <30 — oxali/cape unsafe)REG-ATEZO-BEV- Atezolizumab + BevacizumabREG-BEV-MAINTENANCE-OVARIAN- Bevacizumab maintenance (post 1L platinum, ovarian/fallopian/primary peritoneal)REG-BEVACIZUMAB-GBM- Bevacizumab for recurrent GBMREG-CAPE-BEV-MAINTENANCE- Capecitabine + Bevacizumab maintenance (post-FOLFOX/CapOx induction, mCRC)REG-CARBO-GEM-BEV-OVARIAN- Carboplatin + Gemcitabine + Bevacizumab (platinum-sensitive recurrent ovarian, OCEANS reg...REG-CARBO-PLD-BEV-OVARIAN- Carboplatin + PLD + Bevacizumab (platinum-sensitive recurrent ovarian)REG-FOLFIRI-BEV- FOLFIRI + Bevacizumab (or ± cetuximab if RAS-WT left-sided)REG-FOLFOX-BEV- FOLFOX + BevacizumabREG-FOLFOXIRI-BEV- FOLFOXIRI + BevacizumabREG-PEMBRO-PACLI-CARBO-BEV-CERVICAL- Pembrolizumab + paclitaxel + carboplatin ± bevacizumab (cervical cancer, 1L)REG-PEMBROLIZUMAB-CERVICAL-1L- Pembrolizumab + carboplatin + paclitaxel ± bevacizumab (persistent/recurrent/metastatic c...REG-PLD-BEV-OVARIAN- PLD + Bevacizumab (platinum-resistant recurrent ovarian, AURELIA)REG-TRIFLURIDINE-TIPIRACIL-BEV- Trifluridine-Tipiracil + Bevacizumab (SUNLIGHT) — 3L+ mCRCREG-WEEKLY-PAC-BEV-OVARIAN- Weekly Paclitaxel + Bevacizumab (platinum-resistant recurrent ovarian, AURELIA)