Bevacizumab and Sutent

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using bevacizumab together with SUNItinib. Combining these medications has been associated with a rare type of anemia caused by blood clots forming in small blood vessels. Red blood cells traveling through these vessels may become impaired or injured, resulting in anemia. You may also be more likely to experience other side effects such as high blood pressure, diarrhea, loss of appetite, dehydration, mouth sores, bleeding complications, and infection. Contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration of bevacizumab and sunitinib in patients with solid tumors has been associated with microangiopathic hemolytic anemia (MAHA), a rare type of hemolytic anemia primarily caused by thrombotic lesions in the microvessels. The mechanism of interaction is unknown. In a phase I dose-escalation study, 25 patients with metastatic renal cell carcinoma received a fixed dose of bevacizumab (10 mg/kg) intravenously every 2 weeks and escalating doses of sunitinib (25 to 50 mg) orally daily in a 4 weeks on, 2 weeks off schedule. Five of 12 patients at the highest sunitinib dosage exhibited laboratory findings consistent with MAHA. Two of the cases were considered severe, with findings of thrombocytopenia, anemia, reticulocytosis, reduced serum haptoglobin, schistocytes on peripheral smear, modestly increased serum creatinine levels, severe (grade 3 to 4) hypertension, reversible posterior leukoencephalopathy syndrome (RPLS), and proteinuria--all of which were reversible within three weeks after discontinuing both drugs without additional interventions. In a phase 2 trial, two of seven patients receiving the same combination for the first-line treatment of metastatic renal cell carcinoma were also found to have MAHA, which resulted in closure of the trial. Overall, the seven patients who developed MAHA in the two trials ranged in age from 41 to 76. Time of onset was reported in five cases and ranged from 14 to 196 days. Two additional phase 2 studies of bevacizumab in combination with sunitinib and chemotherapy in patients with solid tumors have also been closed due to poor tolerability primarily related to myelosuppression, fatigue, and gastrointestinal complications such as diarrhea, anorexia, dehydration, and stomatitis. However, no cases of MAHA were reported in these studies.

MANAGEMENT: Based on existing data, the use of bevacizumab in combination with sunitinib is not recommended.

Bevacizumab

Generic Name: bevacizumab

Brand name: Avastin, Mvasi

Synonyms: n.a.

What is Bevacizumab?

Sutent

Generic Name: sunitinib

Brand name: Sutent

Synonyms: n.a.

What is Sutent?