Bevacizumab

Grey

Brand Name(s):Avastin

Indication:Epithelial ovarian, fallopian tube or primary peritoneal cancers (advanced)

Rationale:1

Considered:Jan-07

Review Date:Oct-25

Comments:
NICE TA353
Bevacizumab for treating relapsed, platinum resistant epithelial ovarian, fallopian tube or primary peritoneal cancer (terminated appraisal)
Aug 2015
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Technology appraisals, TA284 – Issued: May 2013
NICE does not recommend bevacizumab, given with paclitaxel and carboplatin, as first-line treatment for advanced ovarian cancer (including fallopian tube and primary peritoneal cancer).
Technology appraisals, TA285 – Issued: May 2013
NICE does not recommend bevacizumab given with gemcitabine and carboplatin for treating adults with the first recurrence of platinum-sensitive advanced ovarian cancer (including fallopian tube or primary peritoneal cancer) that has not been previously treated with bevacizumab or other vascular endothelial growth factor inhibitors.
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Advice for healthcare professionals:

* Treatment with bevacizumab or sunitinib may be a risk factor for the development of ONJ
* Patients treated who have previously received, or are treated concurrently with, bisphosphonates may be particularly at risk
* Dental examination and appropriate preventive dentistry should be considered before treatment with bevacizumab or sunitinib. Invasive dental procedures should be avoided, if possible, in patients treated with bevacizumab or sunitinib who have previously received, or who are receiving, intravenous bisphosphonates

MHRA Drug safety update Volume 4 Issue 6 January 2011

Roche Products Limited would like to inform you of an important update to the safety information regarding the use of AVASTIN (bevacizumab).

Cases of osteonecrosis of the jaw (ONJ) have been reported in cancer patients in association with Avastin treatment, the majority of whom had received prior or concomitant treatment with i.v. bisphosphonates.

Avastin treatment may be an additional risk factor for the development of osteonecrosis of the jaw.

This potential risk should be particularly considered when Avastin and bisphosphonates are administered simultaneously or sequentially.

Dental examination and appropriate preventitive dentistry should be considered prior to treatment with Avastin. In patients who have previously received or are receiving i.v. bisphosphonates invasive dental procedures should be avoided, if possible.

Osteonecrosis of the jaw in cancer patients in association with bevacizumab, Avastin and concomitant or previous use of bisphosphonates MHRA November 2010

Healthcare professionals are advised to be aware that infusion reactions and hypersensitivity reactions have been reported commonly (?1/100–<1/10) during treatment with Avastin. The incidence of such reactions is estimated to be up to 5% in clinical trials. Symptoms reported have included dyspnoea, flushing, rash, hypotension or hypertension, oxygen desaturation, chest pain, rigors, and nausea or vomiting. These reactions normally resolve quickly if the infusion is stopped immediately. Treatment with corticosteroids, antihistamines, oxygen, and intravenous fluids may also be administered as clinically indicated. MHRA Drug Safety Update Volume 3 Issue 11 June 2010