Taking ZIRABEV™ (bevacizumab-bvzr)

How will I receive
treatment with ZIRABEV?

ZIRABEV is given by a health care provider as an intravenous (IV) infusion. That means you get ZIRABEV through a needle in your vein
If you’ve had surgery you cannot receive ZIRABEV until at least 28 days following surgery and the wound is fully healed

How often do I have
to receive ZIRABEV?

Depending on your specific type of cancer, you may receive ZIRABEV every 2 to 3 weeks with or without additional treatment you may be prescribed
If you have questions about how often you'll receive ZIRABEV, speak with your health care team

How long will it take?

If your ZIRABEV infusions are tolerated:

90 minutes: 1st infusion

60 minutes: 2nd infusion

30 minutes: 3rd and future infusions

NOTE: You always get the same dosage of ZIRABEV. If your ZIRABEV infusions are tolerated, they can take as little as 30 minutes.

Metastatic Colorectal Cancer (mCRC)

Every 2 or 3 weeks in combination with intravenous fluorouracil-based chemotherapy

Non-Small Cell Lung Cancer (NSCLC)

Every 3 weeks in combination with carboplatin and paclitaxel

Recurrent Glioblastoma (GBM)

Every 2 weeks

Metastatic Renal Cell Carcinoma (mRCC)

Every 2 weeks in combination with interferon alfa

Advanced Cervical Cancer (CC)

Every 3 weeks in combination with paclitaxel and cisplatin or in combination with paclitaxel and topotecan

Ovarian Cancer (OC)

Advanced (stage III or IV) epithelial ovarian, fallopian tube, or primary peritoneal cancer—every 3 weeks in combination with carboplatin and paclitaxel, followed by ZIRABEV every 3 weeks as a single agent
Platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer—every 2 or 3 weeks in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (every 1 or 3 weeks)
Platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer—every 3 weeks in combination with carboplatin and paclitaxel or with carboplatin and gemcitabine, followed by ZIRABEV every 3 weeks as a single agent

Possible serious side effects of ZIRABEV

Everyone reacts differently to ZIRABEV therapy, so it's important to know what the side effects are.

ZIRABEV may cause serious side effects that can be life-threatening. Your doctor will stop treatment if any serious side effects occur.

Be sure to contact your health care team if there are any signs of these side effects.

Most serious side effects (not common, but sometimes fatal) include:

GI perforation and fistulae

A hole that develops in your stomach or intestine. Symptoms include pain in your abdomen, nausea, vomiting, constipation, or fever.

The development of an abnormal passageway between 2 organs (fistula). Symptoms may vary depending on location and organs involved.

Wounds that don't heal

A cut made during surgery can be slow to heal or may not fully heal. Do not undergo surgery without first discussing this potential risk with your doctor.

Serious bleeding

This includes vomiting or coughing up blood; bleeding in the stomach, brain, or spinal cord; nosebleeds; and vaginal bleeding. If you recently coughed up blood or had serious bleeding, be sure to tell your doctor.

Discuss your ZIRABEV treatment schedule with your health care provider.

IMPORTANT SAFETY INFORMATION AND INDICATIONS

IMPORTANT SAFETY INFORMATION

Possible serious side effects

Everyone reacts differently to ZIRABEV therapy, so it's important to know what the side effects are. ZIRABEV may cause serious side effects that can be life-threatening. Your doctor will stop treatment if any serious side effects occur. Be sure to contact your health care team if there are any signs of these side effects.

Most serious side effects (not common, but sometimes fatal):

GI perforation. A hole that develops in your stomach or intestine. Symptoms include pain in your abdomen, nausea, vomiting, constipation, or fever
Wounds that don't heal. A cut made during surgery can be slow to heal or may not fully heal. Do not undergo surgery without first discussing this potential risk with your doctor
Serious bleeding. This includes vomiting or coughing up blood; bleeding in the stomach, brain, or spinal cord; nosebleeds; and vaginal bleeding. If you recently coughed up blood or had serious bleeding, be sure to tell your doctor

Other possible serious side effects:

Abnormal passage in the body. This type of passage—known as a fistula—is an irregular connection from one part of the body to another and can sometimes be fatal
Severe high blood pressure. Blood pressure that severely spikes or shows signs of affecting the brain. Blood pressure should be monitored every 2 to 3 weeks while on ZIRABEV and after stopping treatment
Kidney problems. These may be caused by too much protein in the urine and can sometimes be fatal
Infusion-related reactions. These were uncommon with the first dose of bevacizumab (less than 3% of patients); 0.4% of patients had severe reactions. Infusion reactions include high blood pressure or severe high blood pressure that may lead to stroke, trouble breathing, decreased oxygen in red blood cells, a serious allergic reaction, chest pain, headache, tremors, and excessive sweating. Your doctor or nurse will monitor you for signs of infusion reactions
Severe stroke or heart problems. These may include blood clots, mini-stroke, heart attack, chest pain, and your heart may become too weak to pump blood to other parts of your body (congestive heart failure). These can sometimes be fatal
Nervous system and vision problems. Signs include headache, seizure, high blood pressure, sluggishness, confusion, and blindness

Side effects seen most often

In clinical studies across different types of cancer, some patients treated with bevacizumab experienced the following side effects:

High blood pressure
Too much protein in the urine
Nosebleeds
Bleeding
Back pain
Headache
Taste change
Dry skin
Inflammation of the skin
Inflammation of the nose
Watery eyes

ZIRABEV is not for everyone.

Talk to your doctor if you are:

Undergoing surgery. ZIRABEV should not be used for at least 28 days before or after surgery, and until surgical wounds are fully healed
Pregnant, think you are pregnant, planning to become pregnant, or breastfeeding. Data have shown that bevacizumab products may harm your unborn baby. Use birth control while on ZIRABEV. If you stop ZIRABEV, you should keep using birth control for 6 months before trying to become pregnant. Taking bevacizumab products could cause a woman’s ovaries to stop working and may impair her ability to have children. Breastfeeding while on bevacizumab products may harm your baby, therefore women should not breastfeed during and for 6 months after taking ZIRABEV

INDICATIONS

Metastatic Colorectal Cancer

ZIRABEV is approved to treat metastatic colorectal cancer (mCRC) for:

First- or second-line treatment in combination with intravenous fluorouracil-based chemotherapy
Second-line treatment when used with fluoropyrimidine-based (combined with irinotecan or oxaliplatin) chemotherapy after cancer progresses following a first-line treatment that includes a bevacizumab product

ZIRABEV is not approved for use after the primary treatment of colon cancer that has not spread to other parts of the body.

Non-Small Cell Lung Cancer

ZIRABEV, in combination with carboplatin and paclitaxel, is approved to treat advanced non-squamous non-small cell lung cancer (NSCLC) in people who have not received chemotherapy for their advanced disease.

Recurrent Glioblastoma

ZIRABEV is approved to treat glioblastoma (GBM) in adult patients whose cancer has progressed after prior treatment (recurrent or rGBM).

Metastatic Renal Cell Carcinoma

ZIRABEV, used with interferon alfa, is approved to treat metastatic kidney cancer (mRCC).

Persistent, Recurrent, or Metastatic Cervical Cancer

ZIRABEV, in combination with paclitaxel and cisplatin or paclitaxel and topotecan, is approved to treat persistent, recurrent, or metastatic cancer of the cervix.

Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

ZIRABEV is approved to treat epithelial ovarian, fallopian tube, or primary peritoneal cancer:

In combination with carboplatin and paclitaxel, followed by ZIRABEV alone, for the treatment of patients with advanced (stage III or IV) disease following initial surgery
In combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan, for platinum-resistant recurrent disease in women who received no more than 2 prior chemotherapy treatments
Either in combination with carboplatin and paclitaxel or with carboplatin and gemcitabine, followed by ZIRABEV alone, for patients with platinum-sensitive recurrent disease

If you have any questions about your condition or treatment, talk to your doctor.

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/MedWatch. You may also report side effects to Pfizer at 1-800-438-1985.

Please see Full Prescribing Information for additional Important Safety Information.

ZIRABEV is a registered trademark of Pfizer Inc.
Avastin is a registered trademark of Genentech, Inc.

How will I receive treatment with ZIRABEV?

How often do I have to receive ZIRABEV?