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Avastin is approved for:• Metastatic colorectal cancer (mCRC) for first- or second-line treatment in combination with intravenous 5-fluorouracil–based chemotherapy. It is also

approved to treat mCRC for second-line treatment when used with fluoropyrimidine-based (combined with irinotecan or oxaliplatin) chemotherapy after cancer progresses following a first-line treatment that includes Avastin. Avastin is not approved for use after the primary treatment of colon cancer that has not spread to other parts of the body

• Advanced nonsquamous non–small cell lung cancer (NSCLC) in combination with carboplatin and paclitaxel in people who have not received chemotherapy for their advanced disease

• Metastatic kidney cancer (mRCC) when used with interferon alfa• Advanced cervical cancer (CC) in combination with paclitaxel and cisplatin or paclitaxel and topotecan is approved to treat persistent, recurrent, or

metastatic cancer of the cervix• Recurrent ovarian cancer (rOC). Avastin in combination with paclitaxel, pegylated liposomal doxorubicin or topotecan, is approved to treat platinum-

resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer (prOC) in women who received no more than two prior chemotherapy treatments. Avastin, either in combination with carboplatin and paclitaxel or with carboplatin and gemcitabine, followed by Avastin alone, is approved for the treatment of patients with platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer (psOC).

Please see pages throughout this brochure, and accompanying full Product Information, including Serious Side Effects, for additional important safety information.

Additional resourcesIf you’d like to join a support group, ask your health care team if there’s one in your area. Here are some national organizations that provide services to patients with cancer and their families:

American Cancer Society Cancer information services, community programs, and research and advocacy resources. Visit www.cancer.org or call 1-800-ACS-2345 (1-800-227-2345)

Cancer.net Web resource providing timely, oncologist-approved information from the American Society of Clinical Oncology to help patients and families make informed health care decisions. Visit www.cancer.net or call 1-888-651-3038

National Cancer Institute The NCI is a component of the National Institutes of Health in the Department of Health and Human Services and provides current information about cancer and clinical trials as well as resources. Visit www.cancer.gov or call 1-800-4-CANCER (1-800-422-6237)

National Comprehensive Cancer Network NCCN creates clinical practice guidelines for use by patients, clinicians, and other health care decision makers with the goal of improving the quality of oncology practice. Visit www.nccn.com or call 1-215-690-0300

Information is provided for informational purposes and convenience only. Genentech is not responsible for the accuracy of the information contained on a third-party site and does not recommend or endorse the content provided on the site. The information provided by Genentech USA, Inc. or these organizations is meant for informational purposes only and is not meant to replace a physician’s medical advice.

CAREGIVER Defining YOUR ROLE AS A

VAN, HUSBAND, FATHER, HANDYMAN

STEP OF THE WAY.”

SHE’S BEEN RIGHT THERE TO SUPPORT ME EVERY

“

© 2016 Genentech USA, Inc., South San Francisco, CA. All rights reserved. December 2016 AVP/111914/0021a(2)

2

Possible serious side effects

The information in this brochure is not meant to be medical advice and should not replace the advice of your doctor.

Everyone reacts differently to Avastin therapy. So it’s important to know what the side effects are.

Although some people may have a life-threatening side effect, most do not. 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.

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

WOUNDS THAT DON’T HEALA cut made during surgery can be slow to heal or may not fully heal. Avastin should not be used for at least 28 days before or after surgery and until surgical wounds are fully healed.

SERIOUS BLEEDINGThis 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.

Chemo Alone + Avastin

FATIGUE 8% 13%

WEAKNESS 7% 10%

TOO MUCH PROTEININ THE URINE 0% 7%

HIGH BLOOD PRESSURE 1% 6%

BLEEDING* 0.3% 3%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

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


GLUE AREA GLUE AREA GLUE AREA GLUE AREA

GLUE AREA GLUE AREA GLUE AREA GLUE AREA

As a caregiver, you can make a difference in how your family member or friend deals with cancer. Giving emotional and practical support to the person you care for can begin by following these steps:

1

2

3

Be informed. Read the Avastin treatment brochure with your family member or friend. Make sure you both understand what to expect from treatment. Visit www.Avastin.com for more information and to hear stories from Avastin patients.

Understand your role. This brochure offers suggestions for ways you can support your friend or family member. There are endless ways to help—find what works for you, and never be afraid to ask for help from others.

Talk to the person you care for. Let them know how you are going to help. Remember that honest communication is the key.

BECOMING A CAREGIVER

3

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CAREGIVING ESSENTIALS

Communication is keyMetastatic cancer changes the patient’s life, your life, and the lives of family members. As a caregiver, you should talk with your friend or family member about these changes. Here are a few tips for creating a healthy dialogue:

Talking with childrenIt can be difficult to tell children what’s happened to mom or dad. But it’s important to be truthful and speak openly about cancer at an age-appropriate level. Let them know that it’s okay to be upset, angry, or scared. Listen to them and be sure to make time for children in any way you can.

• Ask if it’s a good time to talk

• Be supportive, listen, and don’t interrupt

• Practice what you’ll say in advance

• Speak from the heart

• Remember that you can have more than one talk

• Don’t always say “It’ll be okay”

Taking care of yourselfYour role as a caregiver can be a valuable experience. It can also be physically and emotionally draining. Caregivers are often so busy focusing on their family member or friend that they put their own needs and feelings aside.

Keep yourself from feeling overwhelmed by following these tips:

Exercise, eat right, and get enough sleep

Find time to relax

Have regular checkups with your doctor

DEBORAH WIFE, MOTHER,

CAREGIVER

For more caregiver tips and information on support groups, ask your doctor or nurse and visit www.Avastin.com

Know your limits

Ask for help

Join a support group or talk to a counselor


Ever since I’ve known Van, we’ve been best friends. And ever since he was diagnosed

with metastatic kidney cancer, our bond has become stronger and stronger. After

being married for 25 years and having 5 kids together, you realize that you need

to be there for this person in any way you can.

We definitely try to spend a lot of time together. We go camping as a family, and

if something comes up, we just go for it. No regrets. We like to think of ourselves

as a team, and we’re doing our best to fight cancer.

CaregiversA STORY

WIFE, MOTHER, CAREGIVER

SHE’S BEEN

Life .“

“

MY ROCKDeborah THROUGH CANCER AND

8 9

As the caregiver, you are a vital member of your friend or family member’s health care team. Here are a few ways you can help:

Write down any questions that either of you would like to ask the doctor

Offer to go with your family member or friend to medical appointments

Find out if there are any special instructions and treatment tips the doctor recommends

Keep track of medical information and paperwork

Note any changes in symptoms or side effects

By understanding the treatment plan, you can help keep your friend or family member’s treatment on track.


Your role on the health care team

FOLLOWING THE TREATMENT PLAN

Taking Avastin as scheduledHelp the person you care for make all of their scheduled infusions. Avastin is given:

How long to stay on Avastin therapy

*For mCRC patients starting on Avastin first- or second-line, Avastin is taken with IV 5-FU–based chemotherapy. For mCRC patients who continue on Avastin for second-line treatment after a first-line regimen that included Avastin, Avastin is used with fluoropyrimidine-based (combined with irinotecan or oxaliplatin) chemotherapy. Avastin is not approved for use after the primary treatment of colon cancer that has not spread to other parts of the body. For advanced NSCLC, carboplatin and paclitaxel are given for up to 6 cycles. For mRCC, interferon alfa is used for a maximum of 52 weeks. For CC, Avastin is used with paclitaxel and cisplatin or paclitaxel and topotecan. For prOC, Avastin is used with paclitaxel, pegylated liposomal doxorubicin, or topotecan.

Chemo/interferon alfa*

Avastin

The person you care for should still take Avastin as long as the disease is controlled and

side effects are manageable.

Avastin is given every 2 weeks to: • mRCC patients • mCRC patients starting Avastin for first- or

second-line treatment• prOC patients when used with paclitaxel, pegylated

liposomal doxorubicin, or weekly topotecan

Avastin is given every 3 weeks to: • NSCLC patients• mCRC patients continuing on Avastin

for second-line treatment after a first-line regimen that included Avastin

• prOC patients when used with topotecan every 3 weeks• CC patients

Every

2

weeks

Every

3

weeks

Because Avastin is given as an infusion, infusion reactions may occur. The doctor or nurse will stop Avastin infusions if infusion reactions are severe. The doctor or nurse will monitor your friend or family member for signs of an infusion reaction, which may 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.

10

OTHER POSSIBLE SERIOUS SIDE EFFECTS

% = Percentage of patients who had this side effect in clinical studies

Across different cancers

KIDNEY PROBLEMSThese may be caused by too much protein in the urine and can sometimes be fatal.

SEVERE STROKE OR HEART PROBLEMSThese may include blood clots, mini-stroke, heart attack, and chest pain. These can sometimes be fatal.

NERVOUS SYSTEM AND VISION PROBLEMSSigns include headache, seizure, high blood pressure, sluggishness, confusion, and blindness.

ABNORMAL PASSAGE IN THE BODYThis type of passage—known as a fistula—is an irregular connectionfrom 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 Avastin and after stopping treatment.

UP TO

18%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

7%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

INFUSION REACTIONSThese were uncommon with the first dose (less than 3% of patients). 0.2% 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.

3%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

2.6%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%2% 0.5%


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

10.6%

Up to

8.3%

A BLOOD CLOT IN THE VEINS This may lead to mini-stroke, heart attack, and chest pain, which could be fatal.

ABNORMAL PASSAGE IN THE BODYThis passage—known as a fistula—is a connection between 2 organs and can sometimes be fatal.

• 8.3% of patients developed a fistula between an organ in the digestive system and the vagina

• 1.8% developed a fistula between 2 non-digestive organs

Specific to advanced cervical cancer


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

11Please see pages throughout this brochure, and accompanying full Product Information, including Serious Side Effects, for additional important safety information.

12 13

Most common side effects

In clinical studies across different types of cancers, some patients experienced the following side effects:

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


FATIGUE 8% 13%

WEAKNESS 7% 10%



BLEEDING* 0.3% 3%

• HIGH BLOOD PRESSURE • TASTE CHANGE

• TOO MUCH PROTEIN IN THE URINE • DRY SKIN

• NOSEBLEEDS • INFLAMMATION OF THE SKIN

• RECTAL BLEEDING • INFLAMMATION OF THE NOSE

• BACK PAIN • WATERY EYES

• HEADACHE

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 Genentech at 1-888-835-2555.

Avastin is not for everyone

Talk to your doctor if you are:

UNDERGOING SURGERY Avastin should not be used for 28 days before or after surgery and until surgical wounds are fully healed.

PREGNANT, OR THINK YOU ARE PREGNANTData have shown that Avastin may harm your unborn baby. Use birth control while on Avastin. If you stop Avastin, you should keep using birth control for 6 months before trying to become pregnant.

PLANNING TO BECOME PREGNANTTaking Avastin could cause a woman’s ovaries to stop working and may impair her ability to have children.

BREASTFEEDINGBreastfeeding while on Avastin may harm your baby and is therefore not recommended.


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VISIT WWW.AVASTIN.COMCall 1-877-4AVASTIN (1-877-428-2784) for support 7 days a week

Notes:

















STEP OF THE WAY.”


“


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VISIT WWW.AVASTIN.COMCall 1-877-4AVASTIN (1-877-428-2784) for support 7 days a week

Notes:

















STEP OF THE WAY.”


“


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