Abevmy: Uses, Dosage & Side Effects
A bevacizumab biosimilar – humanized monoclonal antibody targeting VEGF for the treatment of advanced colorectal, lung, kidney, ovarian, and cervical cancers
Abevmy (bevacizumab) is a biosimilar monoclonal antibody used in the treatment of several types of advanced cancer. It works by blocking vascular endothelial growth factor (VEGF), a protein that stimulates the growth of new blood vessels that supply tumors with nutrients and oxygen. By inhibiting VEGF, Abevmy starves tumors of their blood supply, slowing or stopping tumor growth. Abevmy is approved for advanced colorectal cancer, metastatic breast cancer, advanced non-small cell lung cancer, advanced renal cell carcinoma (kidney cancer), advanced ovarian cancer, and persistent or recurrent cervical cancer. It is always given together with chemotherapy or other anticancer agents as an intravenous infusion in a hospital or clinic setting. Abevmy is a biosimilar of Avastin, meaning it has been shown through rigorous comparative studies to have equivalent quality, safety, and efficacy to the reference product.
Quick Facts: Abevmy
Key Takeaways
- Abevmy (bevacizumab) is a VEGF inhibitor biosimilar of Avastin that blocks the growth of new blood vessels feeding tumors, used in combination with chemotherapy for multiple types of advanced cancer including colorectal, lung, breast, kidney, ovarian, and cervical cancers.
- Serious but uncommon side effects include gastrointestinal perforation (holes in the bowel wall), severe hemorrhage (particularly in lung cancer patients), arterial thromboembolic events (heart attack, stroke), and posterior reversible encephalopathy syndrome (PRES).
- Treatment must be temporarily suspended before and after surgery, and permanently discontinued if gastrointestinal perforation, serious fistula, severe hemorrhage, arterial thromboembolism, or hypertensive crisis occurs.
- Abevmy must not be used during pregnancy as it can harm the developing fetus by inhibiting new blood vessel formation; effective contraception is required during treatment and for at least 6 months after the last dose.
- The first infusion is given over 90 minutes, the second over 60 minutes if well tolerated, and subsequent infusions may be shortened to 30 minutes; dosing depends on body weight and cancer type (5, 7.5, 10, or 15 mg/kg).
What Is Abevmy and What Is It Used For?
Abevmy contains the active substance bevacizumab, a humanized monoclonal antibody produced by recombinant DNA technology in Chinese hamster ovary (CHO) cells. Monoclonal antibodies are a type of protein normally produced by the immune system to help protect the body against infections and disease. Bevacizumab is specifically engineered to recognize and bind to human vascular endothelial growth factor (VEGF), a key signaling protein involved in the formation of new blood vessels – a process known as angiogenesis.
In normal physiology, angiogenesis plays important roles in wound healing, tissue growth, and reproduction. However, tumors hijack this process to create their own blood supply. Tumors produce large amounts of VEGF, which stimulates the growth of new blood vessels from nearby existing vessels toward the tumor. These new blood vessels provide the tumor with essential nutrients, oxygen, and a route for cancer cells to spread (metastasize) to other parts of the body. Without an adequate blood supply, tumors generally cannot grow beyond a few millimeters in size.
When bevacizumab binds to VEGF, it prevents VEGF from interacting with its receptors (VEGFR-1 and VEGFR-2) on the surface of endothelial cells that line blood vessels. This blockade has several effects: it inhibits the growth of new tumor blood vessels, causes regression of existing immature tumor vasculature, normalizes the remaining tumor blood vessels (which can paradoxically improve delivery of chemotherapy to the tumor), and reduces tumor interstitial fluid pressure. The net result is that the tumor is deprived of its blood supply, inhibiting growth and potentially causing tumor shrinkage.
Abevmy is a biosimilar of the reference medicine Avastin, which was first approved in the United States in 2004 and in the European Union in 2005. A biosimilar is a biological medicine that is highly similar to an already authorized biological medicine (the reference medicine) in terms of quality, safety, and efficacy. Extensive analytical, non-clinical, and clinical studies have demonstrated that Abevmy is highly similar to Avastin, with no clinically meaningful differences. Other approved bevacizumab biosimilars include MVASI, Zirabev, Aybintio, Oyavas, VEGZELMA, and Alymsys.
Abevmy is approved by the European Medicines Agency (EMA), and equivalent bevacizumab products are approved by the U.S. Food and Drug Administration (FDA) and regulatory authorities worldwide, for the following indications in adult patients:
- Advanced colorectal cancer: Abevmy is used in combination with fluoropyrimidine-based chemotherapy for the treatment of metastatic (spread to other organs) cancer of the colon (large intestine) or rectum. This was the first approved indication for bevacizumab, and it remains one of the most common uses. Landmark trials including AVF2107g demonstrated that adding bevacizumab to chemotherapy significantly improved overall survival in first-line metastatic colorectal cancer.
- Metastatic breast cancer: Abevmy is used in combination with paclitaxel or capecitabine for the first-line treatment of metastatic breast cancer. The E2100 trial showed that bevacizumab combined with paclitaxel significantly improved progression-free survival compared with paclitaxel alone, though the effect on overall survival was not statistically significant.
- Advanced non-small cell lung cancer (NSCLC): Abevmy is used as first-line treatment in combination with platinum-based chemotherapy for unresectable advanced, metastatic, or recurrent non-small cell lung cancer (other than predominantly squamous cell histology). Additionally, for NSCLC with activating EGFR mutations, Abevmy is used in combination with erlotinib as first-line treatment.
- Advanced renal cell carcinoma (kidney cancer): Abevmy is used in combination with interferon alfa-2a for the first-line treatment of adult patients with advanced and/or metastatic renal cell carcinoma. The AVOREN trial demonstrated significant improvement in progression-free survival with this combination.
- Advanced ovarian, fallopian tube, or primary peritoneal cancer: Abevmy is used in several settings: in combination with carboplatin and paclitaxel for first-line treatment of advanced disease (FIGO stages IIIB, IIIC, and IV); in combination with carboplatin and gemcitabin, or with carboplatin and paklitaxel, for platinum-sensitive recurrent disease (relapse after at least 6 months); and in combination with paclitaxel, topotecan, or pegylated liposomal doxorubicin for platinum-resistant recurrent disease (relapse within 6 months). Key trials include GOG-0218, ICON7, OCEANS, and AURELIA.
- Persistent, recurrent, or metastatic cervical cancer: Abevmy is used in combination with paclitaxel and cisplatin, or alternatively with paclitaxel and topotecan for patients who cannot receive platinum-based therapy. The GOG-240 trial demonstrated that adding bevacizumab to chemotherapy significantly improved overall survival in advanced cervical cancer.
Abevmy belongs to a class of medicines called anti-angiogenic agents, which work by preventing the formation of new blood vessels. This approach targets the tumor’s support system rather than the cancer cells directly. Because tumors depend on a blood supply to grow and spread, cutting off this supply is a powerful strategy in cancer treatment. Bevacizumab was the first anti-angiogenic therapy approved for cancer treatment and has been a cornerstone of oncology care for two decades.
What Should You Know Before Receiving Abevmy?
Contraindications
There are specific situations in which Abevmy must not be used. Understanding these absolute contraindications is essential before treatment begins.
- Hypersensitivity: Do not receive Abevmy if you are allergic to bevacizumab or any of the other ingredients in the product (sodium phosphate, trehalose dihydrate, polysorbate 20, or water for injection).
- Allergy to CHO cell products: Bevacizumab is produced in Chinese hamster ovary (CHO) cells. Do not receive Abevmy if you are allergic to CHO cell-derived products or to other recombinant human or humanized antibodies.
- Pregnancy: Abevmy must not be used during pregnancy. Bevacizumab inhibits angiogenesis, which is essential for normal fetal development. Animal studies have shown that bevacizumab can cause embryo-fetal harm, including malformations.
Warnings and Precautions
Abevmy may increase the risk of developing holes in the bowel wall (gastrointestinal perforation), which can be serious or fatal. This risk is higher in patients with intra-abdominal inflammation (such as diverticulitis, stomach ulcers, or colitis associated with chemotherapy). If you experience severe abdominal pain, nausea, vomiting, fever, or constipation, contact your doctor immediately. Treatment will be permanently discontinued if perforation occurs.
Before and during treatment with Abevmy, talk to your doctor if any of the following apply to you:
- Fistula formation: Abevmy may increase the risk of developing abnormal connections between internal organs or between an organ and the skin (fistulae). The risk of vaginal-intestinal fistulae may be increased in patients with persistent, recurrent, or metastatic cervical cancer. If a serious fistula develops, treatment will be permanently discontinued.
- Wound healing complications: Abevmy can impair wound healing. You should not receive this medicine if you are scheduled for surgery, have had major surgery within the last 28 days, or still have unhealed surgical wounds. Treatment is typically withheld for at least 28 days before elective surgery.
- Hemorrhage (bleeding): Abevmy increases the risk of bleeding, including tumor-associated hemorrhage. Severe pulmonary hemorrhage (coughing up blood) has been reported in patients with non-small cell lung cancer. Tell your doctor if you or your family have a history of bleeding disorders or if you are taking blood-thinning medications.
- Hypertension (high blood pressure): Abevmy can increase the incidence of high blood pressure. If you have uncontrolled hypertension, your blood pressure must be brought under control before starting treatment. Blood pressure will be monitored throughout therapy. Treatment must be temporarily suspended for severe hypertension and permanently discontinued for hypertensive crisis or encephalopathy.
- Arterial thromboembolic events: The risk of blood clots in arteries (which can lead to heart attack or stroke) may be increased, particularly in patients over 65 years of age, those with diabetes, or those with a prior history of arterial thromboembolism. Discuss these risk factors with your doctor.
- Venous thromboembolic events: Abevmy may increase the risk of blood clots in veins, including deep vein thrombosis and pulmonary embolism.
- Proteinuria (protein in urine): Abevmy can cause protein to leak into the urine, especially in patients who already have high blood pressure. Your doctor will monitor your urine for protein before and during treatment.
- Heart failure: Abevmy may increase the risk of developing a weakened heart. Inform your doctor if you have ever received anthracycline chemotherapy (e.g., doxorubicin), radiation to the chest, or have any pre-existing heart disease.
- Posterior reversible encephalopathy syndrome (PRES): A rare neurological condition characterized by headache, visual disturbances, confusion, or seizures has been associated with Abevmy treatment. If you experience any of these symptoms, with or without high blood pressure, contact your doctor immediately.
- Aneurysm and artery dissection: If you have or have had an aneurysm (enlargement and weakening of a blood vessel wall) or a tear in a blood vessel wall, inform your doctor before treatment.
- Infections and neutropenia: Abevmy can cause infections and a decreased number of neutrophils (a type of white blood cell important for fighting bacterial infections). Severe skin infections, including necrotizing fasciitis, have been reported, particularly in patients who have had bowel perforations or wound healing problems.
- Osteonecrosis of the jaw: If you experience pain in the mouth, teeth, or jaw, swelling or numbness in the mouth, or loosening of a tooth, inform your doctor and dentist immediately. If you need dental treatment during Abevmy therapy, tell your dentist, particularly if you are also receiving or have received intravenous bisphosphonates.
- Hypersensitivity and infusion reactions: Abevmy can cause allergic reactions, including anaphylactic shock, and infusion-related reactions. Tell your doctor if you have previously experienced problems after injections, such as dizziness, breathing difficulty, swelling, or rash.
Pregnancy and Breastfeeding
Abevmy must not be used during pregnancy. Bevacizumab inhibits angiogenesis, a process that is critical for normal embryonic and fetal development, particularly the formation of new blood vessels needed for organ development. Your doctor will advise you to use effective contraception during treatment and for at least 6 months after the last dose of Abevmy.
Tell your doctor immediately if you are pregnant, become pregnant during treatment, or plan to become pregnant in the near future. Your doctor will discuss the potential risks of continuing or starting therapy.
You must not breastfeed during treatment with Abevmy and for at least 6 months after the last dose, as the medicine may pass into breast milk and could affect the growth and development of your baby.
Abevmy may impair fertility in women. The effect on fertility may be irreversible in some cases. If you are considering having children, discuss this with your doctor before starting treatment.
Children and Adolescents
The use of Abevmy in children and adolescents under 18 years of age is not recommended, as the safety and efficacy have not been established in this age group. Bone tissue death (osteonecrosis) in bones other than the jaw has been reported in patients under 18 years of age treated with bevacizumab.
Driving and Operating Machinery
Abevmy has not been shown to reduce your ability to drive a car or operate tools or machines. However, drowsiness and fainting have been reported with bevacizumab use. If you experience symptoms that affect your vision, concentration, or reaction speed, do not drive or use machines until the symptoms have resolved.
Important Information About Ingredients
This medicine contains sodium. Each 4 mL vial contains 4.196 mg sodium (the main component of table salt), equivalent to 0.21% of the WHO-recommended maximum daily sodium intake for adults. Each 16 mL vial contains 16.784 mg sodium, equivalent to 0.84% of the maximum daily intake. This should be taken into consideration if you are on a sodium-controlled diet.
How Does Abevmy Interact with Other Drugs?
Although formal drug interaction studies have not been extensively conducted with bevacizumab, important clinical observations from trials and post-marketing experience have identified several significant interactions. Bevacizumab is not metabolized by cytochrome P450 enzymes, so direct pharmacokinetic interactions are uncommon. However, pharmacodynamic interactions – where the combined effects of bevacizumab and another drug increase the risk of adverse events – are clinically important. Always inform your healthcare team about all medications, supplements, and herbal products you are taking.
Major Interactions
| Interacting Drug | Effect | Clinical Significance |
|---|---|---|
| Sunitinib malate | Microangiopathic hemolytic anemia (MAHA), severe hypertension, thrombocytopenia | Do not combine – serious risk of hemolytic anemia and multiorgan failure |
| Platinum-based chemotherapy (cisplatin, carboplatin, oxaliplatin) | Increased risk of severe neutropenia, infections, and febrile neutropenia | Standard combination; monitor closely for hematological toxicity |
| Anticoagulants (warfarin, heparin) | Increased risk of hemorrhage when combined with bevacizumab | Use with caution; monitor INR and bleeding signs closely |
| Bisphosphonates (zoledronic acid, pamidronate) | Increased risk of osteonecrosis of the jaw | Dental examination recommended before starting; avoid invasive dental procedures during treatment |
Minor Interactions
| Interacting Drug | Effect | Clinical Significance |
|---|---|---|
| Taxanes (paclitaxel, docetaxel) | Possible increased risk of neutropenia and neuropathy | Standard combination for breast and lung cancer; monitor blood counts |
| Erlotinib (EGFR inhibitor) | Approved combination for EGFR-mutant NSCLC; no unexpected interactions | Well-studied combination; standard of care for selected patients |
| Interferon alfa-2a | Approved combination for renal cell carcinoma; additive side effects | Monitor for flu-like symptoms, fatigue, and depression |
| Radiation therapy | Possible increased risk of wound healing complications and bleeding | Inform your doctor if you have recently received or are currently receiving radiation |
Abevmy is always used in combination with established chemotherapy regimens. The specific combination depends on the type and stage of cancer being treated. Your oncologist will carefully plan your treatment to minimize the risk of cumulative toxicities and will monitor you closely for adverse effects of both the bevacizumab and the chemotherapy components.
What Is the Correct Dosage of Abevmy?
Abevmy is always administered by a doctor or nurse as an intravenous infusion (a drip into a vein). The concentrate must first be diluted with sodium chloride solution (saline) before use. The dose is calculated based on your body weight and the specific cancer indication. Your doctor will determine the appropriate dose, frequency, and duration of treatment based on your clinical response and tolerance.
Dosing by Cancer Type
Advanced Colorectal Cancer
Dose: 5 mg/kg or 10 mg/kg of body weight intravenously
Frequency: Once every 2 weeks (with 5 mg/kg) or once every 3 weeks (with 7.5 mg/kg), depending on the chemotherapy regimen
Combination: Given with fluoropyrimidine-based chemotherapy (e.g., FOLFOX, FOLFIRI, XELOX)
Treatment continues until disease progression or unacceptable toxicity.
Metastatic Breast Cancer
Dose: 10 mg/kg intravenously every 2 weeks (with paclitaxel) or 15 mg/kg every 3 weeks (with capecitabine)
Combination: Given with paclitaxel or capecitabine as first-line treatment
Treatment continues until disease progression or unacceptable toxicity.
Advanced Non-Small Cell Lung Cancer (NSCLC)
Dose: 7.5 mg/kg or 15 mg/kg intravenously every 3 weeks
Combination: Given with platinum-based chemotherapy; or with erlotinib for EGFR-mutant NSCLC
Up to 6 cycles of chemotherapy, followed by Abevmy maintenance as monotherapy until disease progression.
Advanced Renal Cell Carcinoma
Dose: 10 mg/kg intravenously every 2 weeks
Combination: Given with interferon alfa-2a
Treatment continues until disease progression or unacceptable toxicity.
Advanced Ovarian Cancer
Dose: 7.5 mg/kg or 15 mg/kg intravenously every 3 weeks, depending on the specific regimen
Combination: Given with various chemotherapy combinations (carboplatin/paclitaxel, carboplatin/gemcitabine, paclitaxel, topotecan, or pegylated liposomal doxorubicin)
Treatment duration varies by setting: up to 15 months in front-line, or until progression in recurrent disease.
Cervical Cancer
Dose: 15 mg/kg intravenously every 3 weeks
Combination: Given with paclitaxel and cisplatin, or with paclitaxel and topotecan
Treatment continues until disease progression or unacceptable toxicity.
How Abevmy Is Given
Abevmy is a concentrate for solution for infusion. The required dose is withdrawn from the vial and diluted with sodium chloride solution to a total volume typically between 100 mL and 250 mL. The diluted solution is then administered as an intravenous infusion. Do not shake the vial.
- First infusion: Given over 90 minutes to monitor for infusion-related reactions.
- Second infusion: If the first infusion was well tolerated, the second may be given over 60 minutes.
- Subsequent infusions: If the 60-minute infusion was well tolerated, later infusions may be given over 30 minutes.
When Treatment Should Be Interrupted or Stopped
Treatment with Abevmy should be temporarily interrupted if you develop:
- Severe high blood pressure requiring treatment with blood pressure medications
- Problems with wound healing after surgery
- You are about to undergo surgery
Treatment with Abevmy should be permanently discontinued if you develop:
- Severe hypertension that cannot be controlled with medications, or a sudden hypertensive crisis
- Proteinuria combined with body swelling (nephrotic syndrome)
- A hole in the bowel wall (gastrointestinal perforation)
- A serious fistula (abnormal connection between organs or between organs and skin)
- Severe skin or soft tissue infections (necrotizing fasciitis)
- A blood clot in an artery (arterial thromboembolism)
- Pulmonary embolism (blood clot in the lungs)
- Any severe hemorrhage (bleeding)
Missed Dose and Overdose
If you miss an Abevmy infusion, your doctor will decide when to schedule the next dose. Since Abevmy is administered in a clinical setting by healthcare professionals, the risk of missing a dose is managed by your medical team.
If you receive more Abevmy than intended, you may develop a severe migraine headache. If this occurs, tell your doctor, nurse, or pharmacist immediately. Overdose management is symptomatic, as there is no specific antidote for bevacizumab.
Abevmy is always prepared and administered by trained healthcare professionals in a hospital or specialized clinic setting. You will not self-administer this medication at home. Each infusion is carefully calculated based on your body weight and cancer type. Do not stop treatment without discussing it with your doctor, as stopping may allow the tumor to resume growing.
What Are the Side Effects of Abevmy?
Like all medicines, Abevmy can cause side effects, although not everyone gets them. The side effects listed below were observed when bevacizumab was given together with chemotherapy. This does not necessarily mean that these side effects were caused by bevacizumab alone. If you experience any side effects, including those not listed below, talk to your doctor, nurse, or pharmacist.
Allergic Reactions
If you experience an allergic reaction during or after an infusion, tell your doctor or nurse immediately. Signs may include difficulty breathing, chest pain, skin flushing or rash, chills and shivering, nausea or vomiting, swelling, dizziness, rapid heartbeat, or loss of consciousness. In rare cases, severe anaphylactic shock may occur.
Side Effects by Frequency
Very Common
May affect more than 1 in 10 people
- High blood pressure (hypertension)
- Numbness or tingling in hands or feet (peripheral neuropathy)
- Decreased white blood cells (neutropenia, leukopenia) – may occur with fever
- Decreased platelets (thrombocytopenia)
- Weakness and lack of energy (asthenia)
- Fatigue
- Diarrhea, nausea, vomiting, and abdominal pain
- Loss of appetite
- Constipation
- Fever
- Eye problems (including increased tearing)
- Speech disturbances
- Taste changes
- Runny nose
- Dry skin, skin peeling and inflammation, skin color changes
- Weight loss
- Nosebleeds
Common
May affect up to 1 in 10 people
- Gastrointestinal perforation (holes in the bowel)
- Hemorrhage, including pulmonary hemorrhage in lung cancer patients
- Arterial thromboembolism (blood clots in arteries)
- Venous thromboembolism (blood clots in veins, including deep vein thrombosis)
- Pulmonary embolism (blood clots in lung vessels)
- Heart failure
- Wound healing problems after surgery
- Hand-foot syndrome (redness, pain, peeling, or blistering on fingers or toes)
- Decreased red blood cells (anemia)
- Muscle and joint pain, muscle weakness
- Dry mouth with thirst and/or decreased or dark-colored urine
- Inflammation of mucous membranes (mouth, stomach, lungs, reproductive/urinary tract)
- Mouth and esophageal ulcers
- Pain (headache, back pain, pelvic pain)
- Localized abscess formation
- Infections, particularly blood or urinary tract infections
- Reduced blood supply to the brain, or stroke
- Sleepiness
- Increased heart rate
- Bowel obstruction
- Proteinuria (protein in urine)
- Shortness of breath or low blood oxygen levels
- Skin or deep tissue infections
- Fistula (abnormal connections between organs), including vaginal-intestinal fistulae in cervical cancer patients
- Allergic reactions (difficulty breathing, facial flushing, rash, low or high blood pressure, chest pain, nausea/vomiting)
- Voice changes and hoarseness
Rare
May affect up to 1 in 1,000 people
- Anaphylactic shock (sudden, severe allergic reaction with difficulty breathing, swelling, dizziness, rapid heartbeat, sweating, and loss of consciousness)
Not Known
Frequency cannot be estimated from available data
- Severe skin or soft tissue infections (necrotizing fasciitis), especially after bowel perforation or wound healing complications
- Impaired female fertility (may be irreversible in some cases)
- Posterior reversible encephalopathy syndrome (PRES) – brain condition with seizures, headache, confusion, and visual changes
- Aneurysm and arterial dissection (enlargement, weakening, or tearing of blood vessel walls)
- Thrombotic microangiopathy of the kidneys (blood clots in tiny kidney vessels)
- Pulmonary hypertension (high blood pressure in lung vessels)
- Nasal septum perforation
- Gastrointestinal or stomach ulcers (may cause black tarry stools, blood in stool, or bloody vomiting)
- Osteonecrosis of the jaw (damage to jawbone associated with pain and inflammation)
- Gallbladder perforation
- Bleeding from the lower large intestine
Patients aged 65 and older have an increased risk of developing arterial thromboembolic events (stroke, heart attack), decreased white blood cells and platelets, diarrhea, nausea, headache, fatigue, and high blood pressure during bevacizumab treatment. Your doctor will monitor you particularly carefully.
Effects on Laboratory Tests
Abevmy may cause changes in laboratory values monitored by your doctor. These include decreased white blood cells (especially neutrophils), protein in urine, decreased potassium/sodium/phosphorus in blood, increased blood sugar, increased alkaline phosphatase, increased serum creatinine, and decreased hemoglobin (which can be serious).
Fertility in Women
Women of reproductive age (those who have regular menstrual cycles) may notice that periods become irregular or stop, and may experience impaired fertility. If you are considering having children, discuss this with your doctor before starting treatment. The effect on fertility may be irreversible in some cases.
Off-Label Eye Use
Bevacizumab was developed and manufactured for injection into the bloodstream to treat cancer. It was not developed or approved for injection into the eye. When injected directly into the eye (an unapproved use), the following side effects may occur: infection or inflammation of the eyeball, redness in the eye, floaters or specks in the visual field, eye pain, light flashes with floaters that may progress to some vision loss, increased eye pressure, and bleeding in the eye.
If you experience any side effects, including those not mentioned here, report them to your doctor, nurse, or pharmacist. You can also report suspected side effects to your national pharmacovigilance authority (e.g., the EMA in Europe, the FDA MedWatch program in the United States, or the MHRA Yellow Card Scheme in the United Kingdom).
How Should Abevmy Be Stored?
Keep this medicine out of the sight and reach of children. Do not use Abevmy after the expiry date stated on the outer carton and vial label after EXP. The expiry date refers to the last day of that month.
- Unopened vials: Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze.
- Light protection: Keep the vial in the outer carton to protect from light.
- Diluted solution: Should be used immediately after dilution. If not used immediately, the in-use storage time and conditions are the responsibility of the user and should normally not exceed 24 hours at 2°C to 8°C, unless dilution has taken place under controlled and validated aseptic conditions.
- Extended stability: Abevmy is stable for up to 70 days at 2°C to 8°C and up to 15 days at 23°C to 27°C.
- Inspection: Do not use if you observe any particles or discoloration before administration.
As Abevmy is prepared and administered in a hospital or clinic, storage is handled by the healthcare team and pharmacy. Do not dispose of any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures help protect the environment.
What Does Abevmy Contain?
Active Substance
The active substance is bevacizumab. Each mL of concentrate contains 25 mg of bevacizumab, which corresponds to 1.4 to 16.5 mg/mL when diluted as recommended.
- 4 mL vial: Contains 100 mg of bevacizumab (corresponds to 1.4 mg/mL when diluted as recommended).
- 16 mL vial: Contains 400 mg of bevacizumab (corresponds to 16.5 mg/mL when diluted as recommended).
Inactive Ingredients (Excipients)
- Sodium phosphate (E339)
- α,α-Trehalose dihydrate
- Polysorbate 20 (E432)
- Water for injection
Appearance and Pack Sizes
Abevmy is a concentrate for solution for infusion. The concentrate is a clear to slightly opalescent, colorless to slightly brown liquid, free from visible particles. It is supplied in a glass vial with a rubber stopper.
- 4 mL vials are available in packs of 1 or 5 vials.
- 16 mL vials are available in packs of 1, 2, or 3 vials.
Not all pack sizes may be marketed in your country.
Manufacturer
Abevmy is manufactured by Biosimilar Collaborations Ireland Limited, Dublin, Ireland. The marketing authorization holder is Biosimilar Collaborations Ireland Limited, Dublin, Ireland. Abevmy is distributed in certain markets by Biocon Biologics.
Frequently Asked Questions About Abevmy
Abevmy (bevacizumab) is used to treat several types of advanced cancer in adults. It is approved for metastatic colorectal cancer (in combination with fluoropyrimidine-based chemotherapy), metastatic breast cancer (with paclitaxel or capecitabine), advanced non-small cell lung cancer (with platinum-based chemotherapy or with erlotinib for EGFR-mutant tumors), advanced renal cell carcinoma (with interferon alfa-2a), advanced ovarian, fallopian tube, or primary peritoneal cancer (with various chemotherapy combinations), and persistent, recurrent, or metastatic cervical cancer (with paclitaxel-containing chemotherapy).
Abevmy is a biosimilar of Avastin, meaning it is a biological medicine that has been shown through extensive comparative analytical, non-clinical, and clinical studies to be highly similar to Avastin in terms of quality, safety, and efficacy. Both contain the same active substance (bevacizumab) and are used at the same doses for the same indications. A biosimilar undergoes rigorous regulatory review before approval. You can expect Abevmy to work the same as Avastin.
The duration of treatment with Abevmy depends on the type of cancer and how you respond to therapy. In general, treatment continues until the cancer progresses (starts growing again) or until side effects become too severe. For some indications, such as first-line ovarian cancer, there is a maximum recommended treatment duration (e.g., up to 15 months including maintenance). Your oncologist will regularly assess your response with scans and blood tests to determine whether treatment should continue.
Abevmy impairs wound healing, so it is important to plan any surgery carefully in relation to your treatment schedule. Treatment with Abevmy should not be started for at least 28 days after major surgery, and the surgical wound should be fully healed. Conversely, Abevmy should be stopped at least 28 days before planned elective surgery. If you develop wound healing complications, treatment should be withheld until the wound is fully healed. Always inform your surgeon that you are receiving or have recently received Abevmy.
High blood pressure (hypertension) is one of the most common side effects of bevacizumab. Your blood pressure will be monitored regularly before and during treatment. If you develop high blood pressure, your doctor may prescribe antihypertensive medications to control it. Most cases can be managed with standard blood pressure medication. However, if your blood pressure becomes severely elevated and cannot be controlled, or if you develop a hypertensive crisis, treatment with Abevmy may need to be temporarily or permanently discontinued. Report any symptoms such as severe headache, vision changes, or confusion to your doctor immediately.
Yes, Abevmy may impair fertility in women. Women of reproductive age may notice irregular or absent menstrual periods during treatment. In some cases, the effect on fertility may be irreversible. If you are considering having children in the future, it is important to discuss this with your oncologist before starting treatment so that fertility preservation options can be explored. Effective contraception must be used during treatment and for at least 6 months after the last dose. The effect on male fertility has not been extensively studied, but men should also discuss any concerns with their doctor.
References
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- U.S. Food and Drug Administration (FDA). Bevacizumab Prescribing Information. Available from: FDA Drug Label.
- Hurwitz H, Fehrenbacher L, Novotny W, et al. Bevacizumab plus Irinotecan, Fluorouracil, and Leucovorin for Metastatic Colorectal Cancer. N Engl J Med. 2004;350(23):2335–2342. doi:10.1056/NEJMoa032691.
- Sandler A, Gray R, Perry MC, et al. Paclitaxel–Carboplatin Alone or with Bevacizumab for Non-Small-Cell Lung Cancer. N Engl J Med. 2006;355(24):2542–2550. doi:10.1056/NEJMoa061884.
- Escudier B, Pluzanska A, Koralewski P, et al. Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma (AVOREN). Lancet. 2007;370(9605):2103–2111. doi:10.1016/S0140-6736(07)61904-7.
- Burger RA, Brady MF, Bookman MA, et al. Incorporation of Bevacizumab in the Primary Treatment of Ovarian Cancer (GOG-0218). N Engl J Med. 2011;365(26):2473–2483. doi:10.1056/NEJMoa1104390.
- Tewari KS, Sill MW, Long HJ III, et al. Improved Survival with Bevacizumab in Advanced Cervical Cancer (GOG-240). N Engl J Med. 2014;370(8):734–743. doi:10.1056/NEJMoa1309748.
- European Society for Medical Oncology (ESMO). Clinical Practice Guidelines: Anti-Angiogenic Therapy in Oncology. 2024.
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Version 2025.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023.
Editorial Team
This article was written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in oncology, hematology, and clinical pharmacology.
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