Bevacizumab (Avastin and Biosimilars): — A Guide for Patients

Your first infusion takes longer than later ones because your team watches for any reaction while it is running. If the first goes without problems, later infusions are shorter. The time also depends on whether other medicines are given on the same day. Your nurse will give you a realistic estimate before you arrive, so you can plan your day.

Bevacizumab starves the tumour by cutting off its blood supply, while chemotherapy directly attacks dividing cancer cells. Together they target the tumour by two different mechanisms at the same time. NCCN and ESMO guidelines support this combination approach for the cancers where bevacizumab is indicated. In a small number of specific situations it is used without chemotherapy, but your oncologist will explain the reasoning behind your particular regimen.

Bevacizumab is not associated with hair loss. Most people receive it alongside chemotherapy, and many chemotherapy drugs do cause hair thinning or loss. If you notice hair changes during treatment, they are almost certainly related to the chemotherapy rather than the bevacizumab. If you are unsure which drug is responsible for a side effect, ask your team — they can usually tell you.

Yes, and it is important to tell your oncology team as early as possible. Bevacizumab significantly slows wound healing, raising the risk of healing complications and infection after an operation. Your oncologist will pause it for a period before any planned surgery and plan when it is safe to restart after the wound has healed. If emergency surgery comes up, make sure the surgical team knows you are receiving bevacizumab — it is directly relevant to their planning and to your recovery.

Response is assessed through imaging — usually CT scans or PET-CT — done at planned intervals during your treatment. Your oncologist will explain the schedule and what they are measuring on each scan. Between scans, there is usually no reliable way to judge from symptoms alone whether the treatment is having an effect, which is why keeping to the scan timetable matters. If you feel significantly worse between appointments, contact your team rather than waiting for the next scheduled scan.

Yes. Bevacizumab is indicated for specific cancer types at specific stages, based on clinical evidence assessed by bodies such as NCCN, ASCO and ESMO. It is not used across all cancers. Even within the cancers where it is approved, not every patient is a candidate — factors such as blood pressure history, recent surgery and bleeding risk affect whether it is safe to give. Being told bevacizumab is not appropriate for you is not a sign that you are out of options; your oncologist will explain which treatment the evidence supports instead.