How Does Bevacizumab Work for Ovarian Cancer?
At a Glance
Bevacizumab (Avastin) is a targeted therapy that treats ovarian cancer by blocking a protein called VEGF, starving the tumor of the blood supply it needs to grow. It is given as an IV infusion and used alongside chemotherapy, as maintenance therapy, or for recurrent disease.
In this answer
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Bevacizumab, commonly known by its brand name Avastin, is a type of targeted therapy often added to standard chemotherapy for ovarian cancer [1]. Unlike traditional chemotherapy, which directly attacks rapidly dividing cells, bevacizumab is an anti-angiogenesis drug [2]. This means it works by preventing the tumor from forming the new blood vessels it needs to grow and spread, effectively “starving” the cancer of oxygen and nutrients [3]. It is widely used across different stages of ovarian cancer treatment, from a patient’s first round of chemotherapy to maintenance therapy and recurrent disease [4].
How Bevacizumab is Given
Bevacizumab is not a pill; it is given directly into your bloodstream as an intravenous (IV) infusion [5]. This is usually done in an outpatient infusion clinic. It is typically given once every three weeks, often on the same day as your chemotherapy if you are receiving them together [5]. The first infusion is given slowly so your care team can monitor you for any allergic reactions, but subsequent infusions can often be completed more quickly.
How Bevacizumab Works
Tumors require a constant blood supply to survive and grow. To get this blood supply, cancer cells release a protein called Vascular Endothelial Growth Factor (VEGF) [2]. Bevacizumab is a specialized protein, known as a monoclonal antibody, designed to seek out and bind to VEGF, neutralizing it before it can create new blood vessels [6]. By cutting off the tumor’s blood supply, bevacizumab can help shrink the cancer or slow its growth [2].
When is Bevacizumab Used?
Bevacizumab can be incorporated into an ovarian cancer treatment plan at several different points:
- During Frontline Chemotherapy: For newly diagnosed patients, bevacizumab is often added to standard frontline chemotherapy drugs, such as carboplatin and paclitaxel [7]. While many newly diagnosed patients can receive it, clinical trials show it provides the most significant survival benefits for high-risk patients (detailed below) [8].
- As Maintenance Therapy: After the initial rounds of chemotherapy are completed, bevacizumab is frequently continued on its own—or alongside a PARP inhibitor like olaparib—as a “maintenance” treatment [9][10]. Maintenance therapy is designed to delay or prevent the cancer from returning by keeping any microscopic remaining disease in check [9].
- For High-Risk or Advanced Disease: Studies show bevacizumab is particularly effective for patients with Stage IV ovarian cancer or Stage III cancer that was suboptimally debulked [11]. Suboptimally debulked means the surgeon could not remove all visible tumors during surgery, leaving behind tumor masses larger than 1 centimeter [12].
- For Recurrent Cancer: If ovarian cancer returns (recurs) after initial treatment, bevacizumab can be used again, whether the cancer is considered platinum-sensitive or platinum-resistant [1].
Important Side Effects to Watch For
Because bevacizumab targets blood vessels, its side effects are different from traditional chemotherapy. While it does not typically cause hair loss or severe nausea on its own, it carries unique risks. Your doctor will monitor you closely, but you should be aware of:
Common Day-to-Day Side Effects
- High Blood Pressure (Hypertension): This is the most common side effect [13]. Your care team will monitor your blood pressure closely. Many patients who develop high blood pressure while on bevacizumab can manage it safely with standard blood pressure pills [14].
- Protein in the Urine (Proteinuria): Bevacizumab can temporarily affect how the kidneys filter proteins [15]. You will have regular urine tests to check your protein levels before each dose [16].
- Minor Bleeding: Because it affects blood vessels, minor bleeding such as nosebleeds (epistaxis) or bleeding gums is very common [5].
Important Safety Risks
- Wound Healing Complications: Bevacizumab significantly impairs your body’s ability to heal wounds [17]. Because of this risk, bevacizumab must be completely stopped for several weeks before and after any surgery, including minor procedures and dental work [5].
- Blood Clots: There is an increased risk of developing blood clots, both in the veins (venous thromboembolism, like a deep vein thrombosis in the leg or a pulmonary embolism in the lungs) and in the arteries (arterial thromboembolism, like a stroke or heart attack) [5].
- Gastrointestinal (Bowel) Perforation: While rare, bevacizumab carries a serious risk of developing a small hole or tear in the wall of the stomach or intestines [18]. This is a medical emergency. Seek immediate medical attention if you experience sudden, severe stomach pain, persistent vomiting, or a high fever [19].
Common questions in this guide
How is bevacizumab given for ovarian cancer?
What are the most common side effects of bevacizumab?
Why do I need to stop bevacizumab before having surgery or dental work?
What is maintenance therapy in ovarian cancer?
What is a serious warning sign to watch for while taking Avastin?
Questions to Ask Your Doctor
Curated prompts to bring to your next appointment.
- 1.Given my specific tumor stage and the amount of tumor removed during surgery, how much clinical benefit should I expect from adding bevacizumab to my treatment plan?
- 2.How will my blood pressure and kidney function be monitored between my IV infusions?
- 3.Are there any over-the-counter medications or supplements I should avoid taking because they might increase my risk of bleeding?
- 4.If I need a procedure, like a dental extraction or minor surgery, exactly how long do I need to hold my bevacizumab doses before and after?
- 5.Am I considered at high risk for blood clots, and should I be taking any preventive blood-thinning medications?
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References
References (19)
- 1
Bevacizumab in ovarian cancer: Clinical data and predictive and prognostic biomarkers.
Lamia MR, Perri E, Baldassarre G, et al.
Clinical and translational medicine 2026; (16(1)):e70591 doi:10.1002/ctm2.70591.
PMID: 41518057 - 2
Direct antitumor activity of bevacizumab: an overlooked mechanism?
Wang Z, Li J, Guo J, Wei P
Frontiers in pharmacology 2024; (15()):1394878 doi:10.3389/fphar.2024.1394878.
PMID: 38716237 - 3
Biological Pathways Involved in Tumor Angiogenesis and Bevacizumab Based Anti-Angiogenic Therapy with Special References to Ovarian Cancer.
Loizzi V, Del Vecchio V, Gargano G, et al.
International journal of molecular sciences 2017; (18(9)) doi:10.3390/ijms18091967.
PMID: 28906427 - 4
Bevacizumab use in the frontline, maintenance and recurrent settings for ovarian cancer.
Haunschild CE, Tewari KS
Future oncology (London, England) 2020; (16(7)):225-246 doi:10.2217/fon-2019-0042.
PMID: 31746224 - 5
Risk of Thrombo-Embolic Events in Ovarian Cancer: Does Bevacizumab Tilt the Scale? A Systematic Review and Meta-Analysis.
Saerens M, De Jaeghere EA, Kanervo H, et al.
Cancers 2021; (13(18)) doi:10.3390/cancers13184603.
PMID: 34572830 - 6
Management of Refractory Gastrointestinal Bleeding in Hereditary Hemorrhagic Telangiectasia with Bevacizumab.
Masood M, Coles M, Sifuentes H
Case reports in gastrointestinal medicine 2021; (2021()):2242178 doi:10.1155/2021/2242178.
PMID: 34306771 - 7
Optimizing Outcomes: Bevacizumab with Carboplatin and Paclitaxel in 5110 Ovarian Cancer Patients-A Systematic Review and Meta-Analysis.
Kim YJ, Lee HM, Lee GE, et al.
Pharmaceuticals (Basel, Switzerland) 2024; (17(8)) doi:10.3390/ph17081095.
PMID: 39204200 - 8
Bevacizumab with Chemotherapy as a First-Line Treatment for Advanced Ovarian Cancer in a Serbian Cohort.
Conic I, Nedovic B, Stojnev S, et al.
Medicina (Kaunas, Lithuania) 2022; (58(5)) doi:10.3390/medicina58050607.
PMID: 35630024 - 9
Bevacizumab in ovarian cancer therapy: current advances, clinical challenges, and emerging strategies.
Zhang M, Zhu J, Bao Y, et al.
Frontiers in bioengineering and biotechnology 2025; (13()):1589841 doi:10.3389/fbioe.2025.1589841.
PMID: 40474872 - 10
Olaparib plus bevacizumab first-line maintenance in ovarian cancer: final overall survival results from the PAOLA-1/ENGOT-ov25 trial.
Ray-Coquard I, Leary A, Pignata S, et al.
Annals of oncology : official journal of the European Society for Medical Oncology 2023; (34(8)):681-692 doi:10.1016/j.annonc.2023.05.005.
PMID: 37211045 - 11
Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial.
Oza AM, Cook AD, Pfisterer J, et al.
The Lancet. Oncology 2015; (16(8)):928-36.
PMID: 26115797 - 12
Final Overall Survival of a Randomized Trial of Bevacizumab for Primary Treatment of Ovarian Cancer.
Tewari KS, Burger RA, Enserro D, et al.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2019; (37(26)):2317-2328 doi:10.1200/JCO.19.01009.
PMID: 31216226 - 13
Association of bevacizumab and stroke in ovarian cancer: a systematic review and meta-analysis.
Song L, Liu Y, Chen Z, et al.
Frontiers in neuroscience 2023; (17()):1187957 doi:10.3389/fnins.2023.1187957.
PMID: 37360160 - 14
Bevacizumab significantly increases the risks of hypertension and proteinuria in cancer patients: A systematic review and comprehensive meta-analysis.
Zhao T, Wang X, Xu T, et al.
Oncotarget 2017; (8(31)):51492-51506 doi:10.18632/oncotarget.18190.
PMID: 28881662 - 15
Effect of Metformin on vascular endothelial injury in patients with non-small cell lung cancer treated with chemotherapy combined with bevacizumab.
Li H, Pu Z, Fang J
Cancer chemotherapy and pharmacology 2025; (95(1)):59 doi:10.1007/s00280-025-04780-x.
PMID: 40522519 - 16
Austria-based real-world data on bevacizumab in newly diagnosed epithelial ovarian cancer.
Tsibulak I, Polterauer S, Reinthaller A, et al.
Wiener klinische Wochenschrift 2022; (134(19-20)):693-696 doi:10.1007/s00508-022-02005-2.
PMID: 35146539 - 17
Association of Systemic or Intravitreal Antivascular Endothelial Growth Factor (Anti-VEGF) and Impaired Wound Healing in Pediatric Patients: Collagen to the Rescue.
Boyar V
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society 2021; (48(3)):256-261 doi:10.1097/WON.0000000000000764.
PMID: 33951716 - 18
The benefits and pitfalls of adding bevacizumab to neoadjuvant chemotherapy for advanced ovarian cancer: a meta-analysis.
Zhao Z, Cheng L, Tong X, et al.
Future oncology (London, England) 2025; (21(22)):2921-2929 doi:10.1080/14796694.2025.2548188.
PMID: 40844157 - 19
Incidence of gastrointestinal perforation associated with bevacizumab in combination with neoadjuvant chemotherapy as first-line treatment of advanced ovarian, fallopian tube, or peritoneal cancer: analysis of a Japanese healthcare claims database.
Ueda A, Watari H, Mandai M, et al.
Journal of gynecologic oncology 2022; (33(6)):e78 doi:10.3802/jgo.2022.33.e78.
PMID: 36245228
This page provides educational information about bevacizumab for ovarian cancer. It does not replace professional medical advice. Always discuss treatment options, timing of surgeries, and side effect management with your oncologist.
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