Avastin Drug Interactions

Effect of antineoplastic agents on bevacizumab pharmacokinetics: No clinically relevant interaction of co-administered chemotherapy on bevacizumab pharmacokinetics was observed based on the results of a population pharmacokinetics analyses. There was neither statistical significance nor clinically relevant differences in bevacizumab clearance in patients receiving Avastin monotherapy compared to patients receiving Avastin in combination with interferon alfa 2a, erlotinib or chemotherapies (IFL, 5-FU/LV, carboplatin/paclitaxel, capecitabine, doxorubicin or cisplatin/gemcitabine).
Effect of bevacizumab on the pharmacokinetics of other antineoplastic agents: No clinically relevant interaction of bevacizumab was observed on the pharmacokinetics of co-administered interferon alfa 2a, erlotinib (and its active metabolite OSI-420), or the chemotherapies irinotecan (and its active metabolite SN38), capecitabine, oxaliplatin (as determined by measurement of free and total platinum), and cisplatin. Conclusions on the impact of bevacizumab on gemcitabine pharmacokinetics cannot be drawn.
Combination of bevacizumab and sunitinib malate: In two clinical studies of metastatic renal cell carcinoma, microangiopathic haemolytic anaemia (MAHA) was reported in 7 of 19 patients treated with bevacizumab (10 mg/kg every two weeks) and sunitinib malate (50 mg daily) combination.
MAHA is a haemolytic disorder which can present with red cell fragmentation, anaemia, and thrombocytopenia. In addition, hypertension (including hypertensive crisis), elevated creatinine, and neurological symptoms were observed in some of these patients. All of these findings were reversible upon discontinuation of bevacizumab and sunitinib malate (see GENERAL: Hypertension, Proteinuria, Posterior Reversible Encephalopathy Syndrome (PRES) under Precautions).
Radiotherapy: The safety and efficacy of concomitant administration of chemotherapy (temozolomide), radiotherapy and Avastin was evaluated in study BO21990, a Phase III, randomised, double blind, placebo controlled study of 921 patients with newly diagnosed glioblastoma. No new adverse events associated with Avastin were reported in this study.
The safety and efficacy of concomitant administration of radiotherapy and Avastin has not been established in other indications.