Mvasi should notbe administrated until at least 28 days after major surgery and until asurgical wound has healed completely, since it could lead to a delay in woundhealing 19,4.

 The infusion should be infused over 90 minutes. Theinfusion time will reduced to 60 and later 30 minutes if the dose is welltolerated. These are the same regulations as for Avastin 19,20. The prolongedterminal half-life of Mvasi and Avastin (both approximately 20 days) permitsfor dosing schedules of every 2–3 weeks 19,12. Diluted Mvasi and Avastinsolutions should be stored in 2-8°C and used within 8 hours after dilution 19,20.Both mvasi and avastin should not be administrated or mixed with a dextrosesolution as this can lead to aggregation of the mAbs 19,20,24. TargetingAs mentionedbefore, vascular endothelial growth factor is crucial for tumour growth andprogression. Therefore, VEGFA represents an ideal therapeutic target.

Targetedtherapies differ from standard chemotherapy in several ways 25: Targeted therapies act on specific molecular targets that are associated with cancer, whereas most chemotherapies act on all rapidly dividing normal and cancerous cells. They are deliberately designed to interact with their target, whereas many chemotherapies were identified because they kill cells. These therapies are often cytostatic, whereas standard chemotherapy agents are cytotoxic.

Avastin isspecific for, and has a high affinity for, VEGFA; it does not neutralize othermembers of the VEGF family (VEGF-B to -E) 26. As a result of alternative mRNAsplicing, VEGFA exists in at least seven isoforms. Avastin is able to inhibitVEGF isoforms, preventing their binding to receptors and thereby inhibiting theVEGF/VEGF receptor signalling pathway 26,27. mAbs bind to specific epitopes,in this case the epitopes of VEGFA and its isoforms.

This allows for atargeting approach with relatively less and/or nonoverlapping toxicity comparedto other cytotoxic drugs used to treat cancer 27. Mvasi is thought to have thesame way of targeting. In cancer treatment, mAbs have been developed that exerta wide array of pharmacologic effects 6. This also applies for Avastin andMvasi, as both is indicated for multiple types of cancer 19,20.


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