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Avastin (Bevacizumab) 癌思婷

Bevacizumab (trade name Avastin, Genentech/Roche) is a humanized monoclonal antibody that recognizes and blocks vascular endothelial growth factor A (VEGF-A).^[1] VEGF-A is a chemical signal that stimulates the growth of new blood vessels (angiogenesis).

Blood vessels grow uncontrollably in cancer, retinal proliferation of diabetes in the eye, and other diseases. Bevacizumab can block VEGF-A from creating new blood vessels. Bevacizumab was the first clinically available angiogenesis inhibitor in the United States.

Bevacizumab is currently approved by the U.S. Food and Drug Administration (FDA) for cancers that are metastatic (have spread to other parts of the body). It received its first approval in 2004 for combination use with standard chemotherapy for metastatic colon cancer and non-small cell lung cancer.^[2] In 2008, it was approved by the FDA for use in metastatic breast cancer, a decision that generated some controversy as it went against the recommendation of its advisory panel,^[3] who objected because it only slowed tumor growth but failed to extend survival.

Clinical studies are underway in non-metastatic breast cancer, renal cell carcinoma, glioblastoma multiforme, ovarian cancer, castrate-resistant (formally called hormone refractory) prostate cancer, non-metastatic unresectable liver cancer and metastatic or unresectable locally advanced pancreatic cancer. A study released in April 2009 found that bevacizumab is not effective at preventing recurrences of non-metastatic colon cancer following surgery.^[4] In May 2009, it received FDA approval for treatment of recurring glioblastoma multiforme, while treatment for initial growth is still in phase III clinical trial.^[5]