title: Feasibility of rapid infusion of the initial dose of bevacizumab in patients with cancer.
abstract: OBJECTIVE
  Bevacizumab is a monoclonal antibody against vascular endothelial growth factor (VEGF) widely used in clinical oncology. Bevacizumab is commonly co-adminis- tered with chemotherapy. It is recommended that the first infusion of the antibody last 90 min, the second 60 and all subsequent 30 min. Since there is no clear rationale for the proposed schedule of administration, our study assessed the feasibility of a 30 min initial infusion.
  
  
  METHODS
  Cancer patients eligible for de novo bevacizumab treatment were enrolled. All patients received standard bevacizumab dose of 5, 7.5 or 10 mg/kg according to the indication, diluted in 250 ml normal saline, as a 30-min intravenous infusion.
  
  
  RESULTS
  Thirty two patients were enrolled: male 18, female 14, median age 58 years, range 42-78. Oncologic diagnosis: lung cancer 16, colorectal 4, breast 3, ovarian 7, renal 2. All patients tolerated the infusion well. No hypersensitivity reactions were noted. Mean systolic and diastolic blood pressures were 122 and 73 mm/Hg respectively prior to the infusion and 125 and 75 mm/Hg 15 min after the infusion (p=0.3). During the observation period of 1 hour, blood pressure did not change. Transient grade 3 systolic hypertension was noted in 1 patient, with spontaneous regression in 45 min.
  
  
  CONCLUSIONS
  Rapid administration of bevacizumab in 30 min, rather than the recommended in the package insert 90 min is feasible and safe. Such a practice limits the time of confinement in the treatment area to patients' satisfaction and would result in cost savings by reducing health resource utilization.
authors.affiliation: Department of Medical Oncology, Interbalkan Medical Center, Pylaia, Thessaloniki, Greece.
authors.forename: Gregory
authors.initials: G
authors.lastname: Makris
authors.forename: Areti
authors.initials: A
authors.lastname: Kantzioura
authors.forename: Maria
authors.initials: M
authors.lastname: Beredima
authors.forename: Maria
authors.initials: M
authors.lastname: Karampola
authors.forename: Christos
authors.initials: C
authors.lastname: Emmanouilides
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab