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    Monoclonal Antibodies for Treating Colorectal Cancer

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    What Are Monoclonal Antibodies?

    Antibodies are substances produced by the immune system in response to foreign invaders such as bacteria or viruses. Antibodies can stick to the invader and help destroy it. Monoclonal antibodies are a specific type of antibody, created in a lab to find and destroy a particular target -- in this case, cancer. Because of their precision, it is hoped that treatment of a tumor with a monoclonal antibody will be more specific than chemotherapy drugs and therefore have fewer side effects.

    Bevacizumab (Avastin)

    Bevacizumab (Avastin) is a first of its kind of monoclonal antibody that shuts down a process called angiogenesis -- the process whereby tumors grow new blood vessels to help them receive the nutrients needed to survive. The class of drugs is called angiogenesis inhibitors or anti-angiogenic drugs.

    Specifically, Avastin stops the action of a substance released by tumors called vascular endothelial growth factor, or VEGF. VEGF binds to certain cells to stimulate new blood vessel formation. Interfering with tumor blood vessels might slow their growth. Avastin is an approved drug to treat advanced colon or rectal cancer that has spread to other organs (metastasized). The drug is not a cure, but studies show that the use of Avastin along with chemotherapy increased survival of patients with metastatic colon cancer by five months.

    Ramucirumab (Cyramza) and ziv-aflibercept (Zaltrap) are newer angiogenesis inhibitors that also work by binding to VEGF receptors.

    How Is Avastin Given?

    Avastin is an injection that is given along with the chemotherapy. The injection is given in a vein (intravenously or IV) every two weeks.

    Studies show that the drug enhances the effects of chemotherapy, but it does not appear to be effective when given alone in patients with colorectal cancer.

    What Are the Possible Side Effects of Avastin?

    Common side effects of Avastin include:

    Serious side effects of Avastin include:

    • Holes in the colon requiring surgical repair
    • Heart attack
    • Chest pain
    • Kidney damage due to increased protein in the urine
    • Decreased ability of wounds to heal (so it shouldn't be used right after surgery)
    • Bleeding or blood clotting problems


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