What is the therapeutic role of bevacizumab injection?

Bevacizumab (Bevacizumab), as a humanized monoclonal antibody drug, is one of the first biologics approved for anti-angiogenesis treatment in the world. Its trade name is "Avastin" and was developed by Genentech, a subsidiary of Roche. The mechanism of action of bevacizumab is not to directly kill cancer cells, but to indirectly inhibit tumor growth and metastasis by intervening in the angiogenesis process that tumors rely on for survival and spread. It has wide application value in the treatment of a variety of malignant solid tumors, especially in advanced or metastatic colorectal cancer, non-small cell lung cancer, renal cell carcinoma, ovarian cancer and hepatocellular carcinoma. It has been included in the treatment guidelines of many countries and regions as a first-line or combination treatment recommendation.

The key reason why bevacizumab can play a significant role in anti-tumor treatment is that it precisely targets vascular endothelial growth factor (VEGF). Tumors require a large amount of nutrients and oxygen during their growth, so they release VEGF signaling proteins to stimulate adjacent normal tissues to form new blood vessel networks, thereby providing themselves with a "nutrient supply line." VEGF is a key molecule that promotes angiogenesis. It can bind to receptors on the surface of vascular endothelial cells and activate a series of downstream signaling pathways to drive the formation and expansion of new blood vessels. As a VEGF inhibitor, bevacizumab can bind to VEGF molecules with high affinity, preventing it from binding to receptors and interrupting the angiogenesis signal chain from the source. This mechanism of action can not only block the formation of new blood vessels, but also cause the degradation of already formed tumor blood vessels, leading to ischemia and hypoxia in tumor tissue, slowing down its growth, and even inducing cell necrosis.

Clinically, bevacizumab is usually used as part of combination therapy, combined with a variety of cytotoxic chemotherapy drugs or other targeted drugs. The injection method is intravenous drip, and is generally administered once every 2 to 3 weeks. The dose and frequency are adjusted according to the specific indications, the patient's body surface area, and the combination plan. The therapeutic effect of its injection can be summarized into several core levels: first, to reduce or delay the growth of tumor volume and improve local control rate; second, to extend progression-free survival (PFS) and overall survival (OS) and improve treatment efficacy; third, to improve patients' quality of life and reduce tumor-related symptoms; fourth, to improve the penetration of other drugs and enhance the overall treatment response by "normalizing" the tumor vascular microenvironment.

It is worth emphasizing that the anti-angiogenic mechanism of bevacizumab is not limited to the field of tumors, but also shows potential in other pathological neovascular related diseases, such as age-related macular degeneration (AMD) and other eye diseases. Its VEGF inhibitory effect can also effectively control the expansion of lesions. However, in tumor treatment, the efficacy of this drug is often accompanied by certain side effects, such as high blood pressure, proteinuria, bleeding tendencies, delayed wound healing, and gastrointestinal perforation. Therefore, clinical use must be strictly monitored and individually adjusted.

At present, in mainland China, bevacizumab's original drug and some domestic biosimilar drugs have been launched and included in the medical insurance catalog, which has greatly improved the accessibility of drugs to patients. The medical insurance payment policies vary slightly from region to region. Generally, reimbursement can only be made after the medication meets the scope of indications and the medication plan is determined through multidisciplinary consultation.

Reference materials:https://www.drugs.com/bevacizumab.html