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Bevacizumab is a humanized monoclonal antibody against vascular endothelial growth factor A (VEGF-A). It is used to treat several different cancers (cervical cancer, metastatic colorectal cancer, glioblastoma, non-squamous non-small cell lung cancer, ovarian, fallopian tube, primary peritoneal cancer, metastatic renal cell carcinoma, and hepatocellular carcinoma ). The administration of bevacizumab inhibits microvascular growth and angiogenesis and is used in cancer treatment to inhibit malignant cell growth and blood vessel formation. It is usually administered in combination with other chemotherapy agents. This activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for members of the interprofessional team in the treatment of patients with bevacizumab. Objectives: Identify the approved indications for bevacizumab. Summarize the mechanism of action of bevacizumab. Review the potential adverse events of bevacizumab. Outline interprofessional team strategies for improving care coordination and communication to advance bevacizumab and improve outcomes in cancer treatment. Access free multiple choice questions on this topic.

Researchers have not yet conducted extensive mutagenicity and carcinogenicity studies. Administration of bevacizumab in monkeys showed adverse effects on general growth and development, fertility, and wound healing. Teratogenicity is suspected based on studies in rabbits. There is no recommended treatment or antidote for an overdose of bevacizumab.[42] Infusion reactions can be severe, requiring discontinuation and early therapy for hypersensitivity reactions requires prompt treatment.[43]

Bevacizumab is usually only prescribed by specific clinicians, including oncologists, rheumatologists, ophthalmologists, immunologists, and ophthalmologists. However, the routine monitoring of patients treated with bevacizumab is done by nurses. Monitoring for signs of an infusion reaction is necessary during infusions with bevacizumab; this will largely be the responsibility of the nursing staff. Additional monitoring includes CBC with differential, blood pressure monitoring every 2 to 3 weeks, and monitoring for proteinuria. Additionally, patient education by healthcare providers should include risk-benefit evaluation and consideration of severe hypertension, gastrointestinal complications, bleeding tendencies, and arterial and venous thromboembolism. Warnings and precautions include GI perforation, bleeding, surgery, and wound healing complications. The pharmacist must educate the patient on the drug's potential benefits and toxicity. Pharmacists must also examine bevacizumab in the context of the patient's overall drug regimen and report any interactions or concerns to the treating physician. Challenging cases may require an oncology-certified pharmacy practitioner. Communication between the clinicians, pharmacists, and nurses who prescribe, dispense and administer this agent is vital to prevent serious adverse effects. Bevacizumab requires all interprofessional healthcare team members to collaborate and communicate to optimize therapy and minimize adverse reactions. [Level 5] In addition, a study examined the outcomes of ovarian cancer by patient-centered care through a multidisciplinary, interprofessional approach involving gynecological surgeons, pathologists, oncologists and collaboration with other healthcare professionals, including nurses, radiologists, nuclear medicine physicians, nutritionists, vascular surgeons, urologists, gynecologists, and psychologists can provide valuable input in all the decision-making steps of ovarian cancer management which translates to better patient outcomes.[44] [Level 5]