Avastin Case Managers

When your patient is enrolled in Avastin Access Solutions, a qualified Case Manager will work with both of you throughout your journey with Avastin.

Case Managers are not healthcare professionals and cannot provide medical advice.

Case Managers can help with:

Enrollment

Answer questions you or your patients may have throughout the enrollment process

Patient Assistance

Help identify potential financial and other assistance for eligible patients

Benefits Investigations (BIs)

Walk your patient through the results of their BI and help them understand next steps. A Case Manager can perform an optional regimen BI if your patient is prescribed a combination of a Genentech Oncology Medicine(s) and another oncology medicine(s).

Prior Authorizations (PAs)

Help you identify if a PA is necessary
Offer resources as you obtain PAs for your patients
Provide PA forms

Specialty Pharmacy (SP) Distribution Support

Determine if a pharmacy is required by your patient’s insurance
Support pharmacy exceptions, if needed
Identify which specialty pharmacies distribute Avastin

To contact a Case Manager:

Call 888-249-4918 or send a message through My Patient Solutions.

The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and healthcare provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.

NEXT: Financial Assistance Options

Indication

Metastatic renal cell carcinoma (mRCC)

Avastin, in combination with interferon alfa, is indicated for the treatment of metastatic renal cell carcinoma.

Serious adverse reactions (Warnings and Precautions)

Serious and sometimes fatal adverse reactions with increased incidence in the Avastin-treated arm vs chemotherapy arm included:
- Gastrointestinal (GI) perforation ranged from 0.3% to 3% of patients across clinical studies
- Non-GI fistulae (<1% to 1.8%, highest in patients with cervical cancer)
- Arterial thromboembolic events (Grade ≥3, 5%, highest in patients with GBM)
- The incidence of wound healing and surgical complications, including serious and fatal complications, is increased in Avastin-treated patients
- Hemorrhage (Grade 3–5) ranged from 0.4% to 7% of patients across clinical studies
- Renal injury and proteinuria
  - Grade 3–4 proteinuria ranged from 0.7% to 7% in clinical studies
  - Nephrotic syndrome (<1%)
Additional serious adverse reactions with increased incidence in the Avastin-treated arm vs chemotherapy arm included:
- Venous thromboembolism (Grade ≥3, 11% seen in GOG-0240)
- Hypertension (Grade 3–4, 5%–18%)
- Posterior reversible encephalopathy syndrome (PRES) (<0.5%)
- Congestive heart failure (CHF): Grade ≥3 left ventricular dysfunction (1%)
Infusion-related reactions with the first dose of Avastin occurred in <3% of patients, and severe reactions occurred in 0.4% of patients
Avoid use in patients with ovarian cancer who have evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction
Inform females of reproductive potential of the risk of ovarian failure prior to initiating treatment with Avastin
An evaluation for the presence of varices is recommended within 6 months of initiation of Avastin in patients with HCC

Pregnancy warning

Based on the mechanism of action and animal studies, Avastin may cause fetal harm
Advise female patients that Avastin may cause fetal harm, and to inform their healthcare provider of a known or suspected pregnancy
Advise females of reproductive potential to use effective contraception during treatment with Avastin and for 6 months after the last dose of Avastin
Advise nursing women not to breastfeed during treatment with Avastin and for 6 months following their last dose of treatment
Avastin may impair fertility

Most common adverse reactions

Across studies, the most common adverse reactions observed in Avastin patients at a rate >10% were:
- Epistaxis
- Headache
- Hypertension
- Rhinitis
- Proteinuria
- Taste alteration
- Dry skin
- Hemorrhage
- Lacrimation disorder
- Back pain
- Exfoliative dermatitis
Across all studies, Avastin was discontinued in 8% to 22% of patients because of adverse reactions

Indication-specific adverse reactions

In mRCC, the most common Grade 3–5 adverse reactions in AVOREN, occurring at a >2% higher incidence in Avastin-treated patients vs controls, were fatigue (13% vs 8%), asthenia (10% vs 7%), proteinuria (7% vs 0%), hypertension (6% vs 1%, including hypertension and hypertensive crisis), and hemorrhage (3% vs 0.3%; including epistaxis, small intestinal hemorrhage, aneurysm ruptured, gastric ulcer hemorrhage, gingival bleeding, hemoptysis, hemorrhage intracranial, large intestinal hemorrhage, respiratory tract hemorrhage, and traumatic hematoma)

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch.
You may also report side effects to Genentech at (888) 835-2555.

Please see full Prescribing Information for additional important safety information.

- Avastin Prescribing Information. Genentech, Inc. 2022.
  
  Avastin Prescribing Information. Genentech, Inc. 2022.
- Hurwitz H, Fehrenbacher L, Novotny W, et al. N Engl J Med. 2004;350:2335-2342. PMID: 15175435
  
  Hurwitz H, Fehrenbacher L, Novotny W, et al. N Engl J Med. 2004;350:2335-2342. PMID: 15175435
- Data on file. Genentech, Inc.
  
  Data on file. Genentech, Inc.
- Bennouna J, Sastre J, Arnold D, et al. Lancet Oncol. 2013;14:29-37.
  
  Bennouna J, Sastre J, Arnold D, et al. Lancet Oncol. 2013;14:29-37.
- Österlund P, Alonso-Orduña V, Schlichting C, et al. Poster presented at: European Society for Medical Oncology Meeting; September 28-October 2, 2012; Vienna, Austria.
  
  Österlund P, Alonso-Orduña V, Schlichting C, et al. Poster presented at: European Society for Medical Oncology Meeting; September 28-October 2, 2012; Vienna, Austria.
- Giantonio BJ, Catalano PJ, Meropol NJ, et al. J Clin Oncol. 2007;25:1539-1544. PMID: 17442997
  
  Giantonio BJ, Catalano PJ, Meropol NJ, et al. J Clin Oncol. 2007;25:1539-1544. PMID: 17442997
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer V.2.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
  
  Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer V.2.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
- Sandler A, Gray R, Perry MC, et al. N Engl J Med. 2006;355:2542-2550. PMID: 17167137
  
  Sandler A, Gray R, Perry MC, et al. N Engl J Med. 2006;355:2542-2550. PMID: 17167137
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
  
  Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
- Sandler AB, Schiller JH, Gray R, et al. J Clin Oncol. 2009;27:1405-1412.
  
  Sandler AB, Schiller JH, Gray R, et al. J Clin Oncol. 2009;27:1405-1412.
- Cohen MH, Gootenberg J, Keegan P, Pazdur R. Oncologist. 2007;12:713-718.
  
  Cohen MH, Gootenberg J, Keegan P, Pazdur R. Oncologist. 2007;12:713-718.
- Sandler A, Leon L, Fages S, et al. Poster presented at: World Conference on Lung Cancer; July 3-7, 2011; Amsterdam, The Netherlands.
  
  Sandler A, Leon L, Fages S, et al. Poster presented at: World Conference on Lung Cancer; July 3-7, 2011; Amsterdam, The Netherlands.
- Escudier B, Bellmunt J, Negrier S, et al. Slides presented at: Annual Meeting of the American Society of Clinical Oncology; May 29-June 2, 2009; Orlando, FL.
  
  Escudier B, Bellmunt J, Negrier S, et al. Slides presented at: Annual Meeting of the American Society of Clinical Oncology; May 29-June 2, 2009; Orlando, FL.
- Escudier B, Pluzanska A, Koralewski P, et al. Lancet. 2007;370:2103-2111. PMID: 18156031
  
  Escudier B, Pluzanska A, Koralewski P, et al. Lancet. 2007;370:2103-2111. PMID: 18156031
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Kidney Cancer V.1.2020. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
  
  Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Kidney Cancer V.1.2020. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
- Tewari KS, Sill MW, Long HJ III, et al. N Engl J Med. 2014;370:734-743 [supplementary appendix appears online].
  
  Tewari KS, Sill MW, Long HJ III, et al. N Engl J Med. 2014;370:734-743 [supplementary appendix appears online].
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Cervical Cancer V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 25, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
  
  Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Cervical Cancer V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 25, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
- Rich JT, Neely JG, Paniello RC, et al. Otolaryngol Head Neck Surg. 2010;143:331-336.
  
  Rich JT, Neely JG, Paniello RC, et al. Otolaryngol Head Neck Surg. 2010;143:331-336.
- Burger RA, Brady MF, Bookman MA, et al. N Engl J Med. 2011;365:2473-2483.
  
  Burger RA, Brady MF, Bookman MA, et al. N Engl J Med. 2011;365:2473-2483.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Ovarian Cancer V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
  
  Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Ovarian Cancer V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
- Aghajanian C, Blank S, Goff B, et al. J Clin Oncol. 2012;30(17):2039-2045.
  
  Aghajanian C, Blank S, Goff B, et al. J Clin Oncol. 2012;30(17):2039-2045.
- Aghajanian C, Goff B, Nycum LR, et al. Gynecol Oncol. 2015;139(1):10-16.
  
  Aghajanian C, Goff B, Nycum LR, et al. Gynecol Oncol. 2015;139(1):10-16.
- Coleman RL, Brady MF, Herzog TJ, et al. Lancet Oncol. 2013;18(6):779-791.
  
  Coleman RL, Brady MF, Herzog TJ, et al. Lancet Oncol. 2013;18(6):779-791.
- Pujade-Lauraine E, Hilpert F, Weber B, et al. J Clin Oncol. 2014;32(13):1302-1308.
  
  Pujade-Lauraine E, Hilpert F, Weber B, et al. J Clin Oncol. 2014;32(13):1302-1308.
- Bevacizumab and lomustine for recurrent GBM. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT01290939. Updated February 21, 2018. Accessed July 24, 2019.
  
  Bevacizumab and lomustine for recurrent GBM. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT01290939. Updated February 21, 2018. Accessed July 24, 2019.
- Friedman HS, Prados MD, Wen PY, et al. J Clin Oncol. 2009;27:4733-4740.
  
  Friedman HS, Prados MD, Wen PY, et al. J Clin Oncol. 2009;27:4733-4740.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
  
  Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 24, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.
- Hicklin DJ, Ellis LM. J Clin Oncol. 2005;23:1011-1027.
  
  Hicklin DJ, Ellis LM. J Clin Oncol. 2005;23:1011-1027.
- Bergers G, Benjamin LE. Nat Rev Cancer. 2003;3:401-410.
  
  Bergers G, Benjamin LE. Nat Rev Cancer. 2003;3:401-410.
- Folkman J. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology. Vol 2. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005:2865-2882.
  
  Folkman J. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology. Vol 2. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005:2865-2882.
- Hanrahan V, Currie MJ, Gunningham SP, et al. J Pathol. 2003;200:183-194.
  
  Hanrahan V, Currie MJ, Gunningham SP, et al. J Pathol. 2003;200:183-194.
- Rini BI, Small EJ. J Clin Oncol. 2005;23:1028-1043.
  
  Rini BI, Small EJ. J Clin Oncol. 2005;23:1028-1043.
- Presta LG, Chen H, O’Connor SJ, et al. Cancer Res. 1997;57:4593-4599.
  
  Presta LG, Chen H, O’Connor SJ, et al. Cancer Res. 1997;57:4593-4599.
- Ferrara N. Endocr Rev. 2004;25:581-611.
  
  Ferrara N. Endocr Rev. 2004;25:581-611.
- Ferrara N, Hillan KJ, Gerber HP, et al. Nat Rev Drug Discov. 2004;3:391-400.
  
  Ferrara N, Hillan KJ, Gerber HP, et al. Nat Rev Drug Discov. 2004;3:391-400.
- O’Connor JPB, Carano RAD, Clamp AR, et al. Clin Cancer Res. 2009;15:6674-6682.
  
  O’Connor JPB, Carano RAD, Clamp AR, et al. Clin Cancer Res. 2009;15:6674-6682.
- Tobelem G. Targ Oncol. 2007;2:153-164.
  
  Tobelem G. Targ Oncol. 2007;2:153-164.
- Yuan F, Chen Y, Dellian M, et al. Proc Natl Acad Sci U S A. 1996;93:14765-14770.
  
  Yuan F, Chen Y, Dellian M, et al. Proc Natl Acad Sci U S A. 1996;93:14765-14770.
- Willett CG, Boucher Y, di Tomaso E, et al. Nat Med. 2004;10:145-147.
  
  Willett CG, Boucher Y, di Tomaso E, et al. Nat Med. 2004;10:145-147.
- Lee CG, Heijn M, di Tomaso E, et al. Cancer Res. 2000;60:5565-5570.
  
  Lee CG, Heijn M, di Tomaso E, et al. Cancer Res. 2000;60:5565-5570.
- Gerber HP, Ferrara N. Cancer Res. 2005;65:671-680.
  
  Gerber HP, Ferrara N. Cancer Res. 2005;65:671-680.
- Yanagisawa M, Yorozu K, Kurasawa M, et al. Anti-Cancer Drugs. 2010;21:687-694.
  
  Yanagisawa M, Yorozu K, Kurasawa M, et al. Anti-Cancer Drugs. 2010;21:687-694.
- Borgström P, Hillan KJ, Sriramarao P, et al. Cancer Res. 1996;56:4032-4039.
  
  Borgström P, Hillan KJ, Sriramarao P, et al. Cancer Res. 1996;56:4032-4039.
- Borgström P, Bourdon MA, Hillan KJ, et al. Prostate. 1998;35:1-10.
  
  Borgström P, Bourdon MA, Hillan KJ, et al. Prostate. 1998;35:1-10.
- Bagri A, Berry L, Gunter B, et al. Clin Cancer Res. 2010;16:3887-3900 [and supplemental appendix].
  
  Bagri A, Berry L, Gunter B, et al. Clin Cancer Res. 2010;16:3887-3900 [and supplemental appendix].
- Warren RS, Yuan H, Matli MR, et al. J Clin Invest. 1995;95:1789-1797.
  
  Warren RS, Yuan H, Matli MR, et al. J Clin Invest. 1995;95:1789-1797.
- Mabuchi S, Terai Y, Morishige K, et al. Clin Cancer Res. 2008;14:7781-7789.
  
  Mabuchi S, Terai Y, Morishige K, et al. Clin Cancer Res. 2008;14:7781-7789.
- Nagy JA, Dvorak AM, Dvorak HF. Annu Rev Pathol. 2007;2:251-275.
  
  Nagy JA, Dvorak AM, Dvorak HF. Annu Rev Pathol. 2007;2:251-275.
- Galizia G, Lieto E, Ferraraccio F, et al. Clin Cancer Res. 2004;10:3490-3499.
  
  Galizia G, Lieto E, Ferraraccio F, et al. Clin Cancer Res. 2004;10:3490-3499.
- Vosseler S, Mirancea N, Bohlen P, et al. Cancer Res. 2005;65:1294-1305.
  
  Vosseler S, Mirancea N, Bohlen P, et al. Cancer Res. 2005;65:1294-1305.
- MMIT Analysis.
  
  MMIT Analysis.
- IQVIA Plantrak Corticosteroid Data.
  
  IQVIA Plantrak Corticosteroid Data.
- HLI lives database.
  
  HLI lives database.