- Gastrointestinal (GI) perforation ranged from 0.3% to 3% of patients across clinical studies
- Non-GI fistulae (
- Arterial thromboembolic events (Grade ≥3, 5%, highest in patients with GBM)
- The incidence of wound healing and surgical complications, including serious and fatal complications, is increased in Avastin-treated patients
- Hemorrhage (Grade 3–5) ranged from 0.4% to 7% of patients across clinical studies
- Renal injury and proteinuria
- Grade 3–4 proteinuria ranged from 0.7% to 7% in clinical studies
- Nephrotic syndrome ( <1%)
- Venous thromboembolism (Grade ≥3, 11% seen in GOG-0240)
- Hypertension (Grade 3–4, 5%–18%)
- Posterior reversible encephalopathy syndrome (PRES) ( <0.5%)
- Congestive heart failure (CHF): Grade ≥3 left ventricular dysfunction (1%)
Pregnancy warning
- Based on the mechanism of action and animal studies, Avastin may cause fetal harm
- Advise female patients that Avastin may cause fetal harm, and to inform their healthcare provider of a known or suspected pregnancy
- Advise females of reproductive potential to use effective contraception during treatment with Avastin and for 6 months after the last dose of Avastin
- Advise nursing women not to breastfeed during treatment with Avastin and for 6 months following their last dose of treatment
- Avastin may impair fertility
Most common adverse reactions
- Across studies, the most common adverse reactions observed in Avastin patients at a rate >10% were:
- Epistaxis
- Headache
- Hypertension
- Rhinitis
- Proteinuria
- Taste alteration
- Dry skin
- Hemorrhage
- Lacrimation disorder
- Back pain
- Exfoliative dermatitis
Indication-specific adverse reactions
- In CC, Grade 3 or 4 adverse reactions in Study GOG-0240, occurring at a higher incidence (≥2%) in 218 patients receiving Avastin plus chemotherapy compared to 222 patients receiving chemotherapy alone, were abdominal pain (12% vs 10%), diarrhea (6% vs 3%), anal fistula (4% vs 0%), proctalgia (3% vs 0%), urinary tract infection (8% vs 6%), cellulitis (3% vs 0.5%), fatigue (14% vs 10%), hypertension (11% vs 0.5%), thrombosis (8% vs 3%), hypokalemia (7% vs 4%), hyponatremia (4% vs 1%), dehydration (4% vs 0.5%), neutropenia (8% vs 4%), lymphopenia (6% vs 3%), back pain (6% vs 3%), and pelvic pain (6% vs 1%)
You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch.
You may also report side effects to Genentech at (888) 835-2555.Please see full Prescribing Information for additional important safety information.
Avastin Prescribing Information. Genentech, Inc. 2022. Avastin Prescribing Information. Genentech, Inc. 2022. Hurwitz H, Fehrenbacher L, Novotny W, et al. N Engl J Med. 2004;350:2335-2342. PMID: 15175435 Hurwitz H, Fehrenbacher L, Novotny W, et al. N Engl J Med. 2004;350:2335-2342. PMID: 15175435 Data on file. Genentech, Inc. Data on file. Genentech, Inc. Bennouna J, Sastre J, Arnold D, et al. Lancet Oncol. 2013;14:29-37. Bennouna J, Sastre J, Arnold D, et al. Lancet Oncol. 2013;14:29-37.Österlund P, Alonso-Orduña V, Schlichting C, et al. Poster presented at: European Society for Medical Oncology Meeting; September 28-October 2, 2012; Vienna, Austria.
Österlund P, Alonso-Orduña V, Schlichting C, et al. Poster presented at: European Society for Medical Oncology Meeting; September 28-October 2, 2012; Vienna, Austria.
Giantonio BJ, Catalano PJ, Meropol NJ, et al. J Clin Oncol. 2007;25:1539-1544. PMID: 17442997 Giantonio BJ, Catalano PJ, Meropol NJ, et al. J Clin Oncol. 2007;25:1539-1544. PMID: 17442997Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer V.2.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer V.2.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Sandler A, Gray R, Perry MC, et al. N Engl J Med. 2006;355:2542-2550. PMID: 17167137 Sandler A, Gray R, Perry MC, et al. N Engl J Med. 2006;355:2542-2550. PMID: 17167137Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Sandler AB, Schiller JH, Gray R, et al. J Clin Oncol. 2009;27:1405-1412. Sandler AB, Schiller JH, Gray R, et al. J Clin Oncol. 2009;27:1405-1412. Cohen MH, Gootenberg J, Keegan P, Pazdur R. Oncologist. 2007;12:713-718. Cohen MH, Gootenberg J, Keegan P, Pazdur R. Oncologist. 2007;12:713-718.Sandler A, Leon L, Fages S, et al. Poster presented at: World Conference on Lung Cancer; July 3-7, 2011; Amsterdam, The Netherlands.
Sandler A, Leon L, Fages S, et al. Poster presented at: World Conference on Lung Cancer; July 3-7, 2011; Amsterdam, The Netherlands.
Escudier B, Bellmunt J, Negrier S, et al. Slides presented at: Annual Meeting of the American Society of Clinical Oncology; May 29-June 2, 2009; Orlando, FL.
Escudier B, Bellmunt J, Negrier S, et al. Slides presented at: Annual Meeting of the American Society of Clinical Oncology; May 29-June 2, 2009; Orlando, FL.
Escudier B, Pluzanska A, Koralewski P, et al. Lancet. 2007;370:2103-2111. PMID: 18156031 Escudier B, Pluzanska A, Koralewski P, et al. Lancet. 2007;370:2103-2111. PMID: 18156031Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Kidney Cancer V.1.2020. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Kidney Cancer V.1.2020. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Tewari KS, Sill MW, Long HJ III, et al. N Engl J Med. 2014;370:734-743 [supplementary appendix appears online].
Tewari KS, Sill MW, Long HJ III, et al. N Engl J Med. 2014;370:734-743 [supplementary appendix appears online].
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Cervical Cancer V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 25, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Cervical Cancer V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 25, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Rich JT, Neely JG, Paniello RC, et al. Otolaryngol Head Neck Surg. 2010;143:331-336. Rich JT, Neely JG, Paniello RC, et al. Otolaryngol Head Neck Surg. 2010;143:331-336. Burger RA, Brady MF, Bookman MA, et al. N Engl J Med. 2011;365:2473-2483. Burger RA, Brady MF, Bookman MA, et al. N Engl J Med. 2011;365:2473-2483.Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Ovarian Cancer V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Ovarian Cancer V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Aghajanian C, Blank S, Goff B, et al. J Clin Oncol. 2012;30(17):2039-2045. Aghajanian C, Blank S, Goff B, et al. J Clin Oncol. 2012;30(17):2039-2045. Aghajanian C, Goff B, Nycum LR, et al. Gynecol Oncol. 2015;139(1):10-16. Aghajanian C, Goff B, Nycum LR, et al. Gynecol Oncol. 2015;139(1):10-16. Coleman RL, Brady MF, Herzog TJ, et al. Lancet Oncol. 2013;18(6):779-791. Coleman RL, Brady MF, Herzog TJ, et al. Lancet Oncol. 2013;18(6):779-791. Pujade-Lauraine E, Hilpert F, Weber B, et al. J Clin Oncol. 2014;32(13):1302-1308. Pujade-Lauraine E, Hilpert F, Weber B, et al. J Clin Oncol. 2014;32(13):1302-1308.Bevacizumab and lomustine for recurrent GBM. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT01290939. Updated February 21, 2018. Accessed July 24, 2019.
Bevacizumab and lomustine for recurrent GBM. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT01290939. Updated February 21, 2018. Accessed July 24, 2019.
Friedman HS, Prados MD, Wen PY, et al. J Clin Oncol. 2009;27:4733-4740. Friedman HS, Prados MD, Wen PY, et al. J Clin Oncol. 2009;27:4733-4740.Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
Hicklin DJ, Ellis LM. J Clin Oncol. 2005;23:1011-1027. Hicklin DJ, Ellis LM. J Clin Oncol. 2005;23:1011-1027. Bergers G, Benjamin LE. Nat Rev Cancer. 2003;3:401-410. Bergers G, Benjamin LE. Nat Rev Cancer. 2003;3:401-410. Hanrahan V, Currie MJ, Gunningham SP, et al. J Pathol. 2003;200:183-194. Hanrahan V, Currie MJ, Gunningham SP, et al. J Pathol. 2003;200:183-194. Rini BI, Small EJ. J Clin Oncol. 2005;23:1028-1043. Rini BI, Small EJ. J Clin Oncol. 2005;23:1028-1043. Presta LG, Chen H, O’Connor SJ, et al. Cancer Res. 1997;57:4593-4599. Presta LG, Chen H, O’Connor SJ, et al. Cancer Res. 1997;57:4593-4599. Ferrara N. Endocr Rev. 2004;25:581-611. Ferrara N. Endocr Rev. 2004;25:581-611. Ferrara N, Hillan KJ, Gerber HP, et al. Nat Rev Drug Discov. 2004;3:391-400. Ferrara N, Hillan KJ, Gerber HP, et al. Nat Rev Drug Discov. 2004;3:391-400. O’Connor JPB, Carano RAD, Clamp AR, et al. Clin Cancer Res. 2009;15:6674-6682. O’Connor JPB, Carano RAD, Clamp AR, et al. Clin Cancer Res. 2009;15:6674-6682. Tobelem G. Targ Oncol. 2007;2:153-164. Tobelem G. Targ Oncol. 2007;2:153-164. Yuan F, Chen Y, Dellian M, et al. Proc Natl Acad Sci U S A. 1996;93:14765-14770. Yuan F, Chen Y, Dellian M, et al. Proc Natl Acad Sci U S A. 1996;93:14765-14770. Willett CG, Boucher Y, di Tomaso E, et al. Nat Med. 2004;10:145-147. Willett CG, Boucher Y, di Tomaso E, et al. Nat Med. 2004;10:145-147. Lee CG, Heijn M, di Tomaso E, et al. Cancer Res. 2000;60:5565-5570. Lee CG, Heijn M, di Tomaso E, et al. Cancer Res. 2000;60:5565-5570. Gerber HP, Ferrara N. Cancer Res. 2005;65:671-680. Gerber HP, Ferrara N. Cancer Res. 2005;65:671-680. Yanagisawa M, Yorozu K, Kurasawa M, et al. Anti-Cancer Drugs. 2010;21:687-694. Yanagisawa M, Yorozu K, Kurasawa M, et al. Anti-Cancer Drugs. 2010;21:687-694. Borgström P, Hillan KJ, Sriramarao P, et al. Cancer Res. 1996;56:4032-4039. Borgström P, Hillan KJ, Sriramarao P, et al. Cancer Res. 1996;56:4032-4039. Borgström P, Bourdon MA, Hillan KJ, et al. Prostate. 1998;35:1-10. Borgström P, Bourdon MA, Hillan KJ, et al. Prostate. 1998;35:1-10. Bagri A, Berry L, Gunter B, et al. Clin Cancer Res. 2010;16:3887-3900 [and supplemental appendix]. Bagri A, Berry L, Gunter B, et al. Clin Cancer Res. 2010;16:3887-3900 [and supplemental appendix]. Warren RS, Yuan H, Matli MR, et al. J Clin Invest. 1995;95:1789-1797. Warren RS, Yuan H, Matli MR, et al. J Clin Invest. 1995;95:1789-1797. Mabuchi S, Terai Y, Morishige K, et al. Clin Cancer Res. 2008;14:7781-7789. Mabuchi S, Terai Y, Morishige K, et al. Clin Cancer Res. 2008;14:7781-7789. Nagy JA, Dvorak AM, Dvorak HF. Annu Rev Pathol. 2007;2:251-275. Nagy JA, Dvorak AM, Dvorak HF. Annu Rev Pathol. 2007;2:251-275. Galizia G, Lieto E, Ferraraccio F, et al. Clin Cancer Res. 2004;10:3490-3499. Galizia G, Lieto E, Ferraraccio F, et al. Clin Cancer Res. 2004;10:3490-3499. Vosseler S, Mirancea N, Bohlen P, et al. Cancer Res. 2005;65:1294-1305. Vosseler S, Mirancea N, Bohlen P, et al. Cancer Res. 2005;65:1294-1305. MMIT Analysis. MMIT Analysis. IQVIA Plantrak Corticosteroid Data. IQVIA Plantrak Corticosteroid Data. HLI lives database. HLI lives database.© 2024 Genentech USA, Inc. All rights reserved. This site is intended for U.S. residents only.
Co-pay Card Support
The BrandX™ Co-pay Card Program may help lower the out-of-pocket costs for your patients.
Terms and Conditions
The Co-pay Program is valid ONLY for patients with commercial (private or non-governmental) insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medicine. Patients using Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD), TRICARE or any other federal or state government program (collectively, “Government Programs”) to pay for their Genentech medicine are not eligible. The Program is not valid for Genentech medicines that are eligible to be reimbursed in their entirety by private insurance plans or other programs.
Under the Program, the patient may pay a co-pay. The final amount owed by a patient may be as little as $0 for the Genentech medicine (see Program specific details). The total patient out-of-pocket cost is dependent on the patient’s health insurance plan. The Program assists with the cost of the Genentech medicine only. It does not assist with the cost of other medicines, procedures or office visit fees. After reaching the maximum annual Program benefit amount, the patient will be responsible for all remaining out-of-pocket expenses. The Program benefit amount cannot exceed the patient’s out-of-pocket expenses for the cost associated with the Genentech medicine. The maximum Program benefit will reset every January 1st. The Program is not health insurance or a benefit plan. The patient’s non-governmental insurance is the primary payer. The Program does not obligate the use of any specific medicine or provider. Patients receiving assistance from charitable free medicine programs (such as the Genentech Patient Foundation) or any other charitable organizations for the same expenses covered by the Program are not eligible. The Program benefit cannot be combined with any other rebate, free trial or a similar offer for the Genentech medicine. No party may seek reimbursement for all or any part of the benefit received through the Program.
The Program may be accepted by participating pharmacies, physicians’ offices or hospitals. Once a patient is enrolled, the Program will honor claims with a date of service that precedes the Program enrollment date up to 180 days. Claims must be submitted within 365 days from the date of service unless otherwise indicated. Use of the Program must be consistent with all relevant health insurance requirements. Participating patients, pharmacies, physicians’ offices and hospitals are responsible for reporting the receipt of all Program benefits as required by any insurer or by law. Program benefits may not be sold, purchased, traded or offered for sale.
The patient or their guardian must be 18 years of age or older to receive Program assistance. The Program is only valid in the United States and U.S. Territories, is void where prohibited by law and shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. Eligible patients will be automatically re-enrolled in the Program on an annual basis. Eligible patients will be removed from the Program after 3 years of inactivity (e.g., no claims submitted in a 3-year timeframe). Program eligibility and automatic re-enrollment are contingent upon the patient’s ability to meet all requirements set forth by the Program. Healthcare providers may not advertise or otherwise use the Program as a means of promoting their services or Genentech medicines to patients. The Program is intended for the patient. Only the patient using the Program may receive the funds made available through the Program. The Program is not intended for third parties who reduce the amount available to the patient or take a portion for their own purposes. Patients with health plans that redirect Genentech Program assistance intended for patient out-of-pocket costs may be subject to alternate Program benefit structures. Genentech reserves the right to rescind, revoke or amend the Program without notice at any time.
- Epistaxis