Zirabev (Bevacizumab-Bvzr)

Description

Zirabev (bevacizumab-bvzr) is a biosimilar to Avastin (bevacizumab), a recombinant humanized monoclonal antibody that binds to vascular endothelial growth factor A (VEGF-A), preventing its interaction with VEGF receptors on endothelial cells. This action inhibits angiogenesis, the formation of new blood vessels, thereby suppressing tumor growth and metastasis. Zirabev is indicated for the treatment of various cancers, including metastatic colorectal cancer, non-squamous non–small cell lung cancer, glioblastoma, renal cell carcinoma, and cervical cancer, among others, depending on the regimen and clinical context.

Directions

Zirabev is administered by intravenous infusion. Dosage and administration schedules vary depending on the type of cancer and treatment regimen. For example:

• Metastatic colorectal cancer: 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks in combination with fluoropyrimidine-based chemotherapy.

• Non–small cell lung cancer: 15 mg/kg every 3 weeks in combination with carboplatin and paclitaxel.

Zirabev should be infused over 90 minutes initially. If tolerated, subsequent infusions may be administered over 60 minutes, then 30 minutes. It should not be administered as an intravenous push or bolus. Premedication is not typically required unless the patient experiences an infusion-related reaction.

Ingredients

Each mL of Zirabev contains:

• Bevacizumab-bvzr (25 mg/mL)

• Trehalose dihydrate

• Sodium phosphate monobasic monohydrate

• Sodium phosphate dibasic anhydrous

• Polysorbate 20

• Water for injection

The solution is preservative-free and must be diluted before infusion.

Contraindications

Zirabev is contraindicated in patients with:

• Known hypersensitivity to bevacizumab-bvzr, bevacizumab, or any of the formulation components

• Recent hemoptysis (=½ teaspoon of red blood) in patients with non–small cell lung cancer

• Untreated central nervous system metastases (in certain indications due to bleeding risk)

Cautions

Zirabev increases the risk of gastrointestinal perforations, wound healing complications, and hemorrhage. It should not be initiated for at least 28 days following major surgery and until surgical wounds are fully healed. Proteinuria and hypertension are common and may require dose modification or treatment discontinuation. Patients should be monitored regularly for blood pressure, urine protein, thromboembolic events, and signs of bleeding or infection. Use during pregnancy may cause fetal harm; effective contraception should be used during treatment and for at least 6 months after the last dose.

Side Effects

Common side effects of Zirabev include:

• Hypertension

• Proteinuria

• Epistaxis

• Headache

• Fatigue

• Diarrhea

• Mucositis

• Arthralgia

• Abdominal pain

• Rash

Serious adverse effects may include:

• Gastrointestinal perforation

• Hemorrhage (e.g., pulmonary, GI, CNS)

• Arterial thromboembolism

• Delayed wound healing

• Nephrotic syndrome

• Reversible posterior leukoencephalopathy syndrome (RPLS)

Product Code : 14594