Indications

Non-Squamous, Non-Small Cell Lung Cancer (see Lung Cancer)

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Breast Cancer (see Breast Cancer)

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Colorectal Cancer (see Colorectal Cancer)

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Glioblastoma Multiforme (see Glioblastoma Multiforme)

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Ischemic Cholangiopathy in Hereditary Hemorrhagic Telangiectasia (see Ischemic Cholangiopathy and Hereditary Hemorrhagic Telangiectasia)

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Ovarian Cancer (see Ovarian Cancer)

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Renal Cell Carcinoma (see Renal Cancer)

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Contraindications

• Squamous Cell Lung Cancer (see Lung Cancer): due to risk of hemorrhage
• Central Nervous System Metastases: due to risk of hemorrhage

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Pharmacology

• Monoclonal Ab Which Binds To and Inhibits Vascular Endothelial Growth Factor (VEGF)
  • Inhibits Tumoral Angiogenesis

Metabolism

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Administration

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Dose Adjustment

• Hepatic
• Renal

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Adverse Effects

Cardiovascular Adverse Effects

• Congestive Heart Failure (CHF) (see Congestive Heart Failure)
  • Epidemiology: mostly when bevacizumab is used in combination with anthracyclines, rasing question of true association
• Hypertension (see Hypertension)

Gastrointestinal Adverse Effects

• Gastrointestinal Perforation (see Small Intestinal Perforation and Colonic Perforation)

Hematologic Adverse Effects

Increased Risk of Thromboembolic Disease (see Hypercoagulable States)

• Epidemiology: 2-fold increased risk
• Physiology: may be due to vascular injury

Drug-Induced Thrombotic Microangiopathy (see Drug-Induced Thrombotic Microangiopathy)

• Clinical
  • Microangiopathic Hemolytic Anemia (MAHA)
  • Hypertension
  • Renal Failure

Neurologic Adverse Effects

• Posterior Reversible Encephalopathy Syndrome (PRES) (see Posterior Reversible Encephalopathy Syndrome)

Pulmonary Adverse Effects

• Pulmonary Hemorrhage from Lung Cancer Tumor Necrosis (see Lung Cancer)
  • Prognosis: fatalities have been reported

Other Adverse Effects

• Impaired Wound Healing
• Osteonecrosis of the Jaw
• Ovarian Failure

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References

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