Defining
YOUR ROLE AS A
CAREGIVER
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
• Platinum-resistant ovarian cancer (prOC) in combination with paclitaxel, pegylated liposomal doxorubicin or topotecan, is approved to treat
platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer in women who received no more than two prior
chemotherapy treatments
Please see pages 2, 10-13, and accompanying full Product Information, including Serious Side Effects, for additional important safety information.
BECOMING A CAREGIVER
Possible serious side effects
Everyone reacts differently to Avastin
therapy. So it’s important to know what
the side effects are.
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:
Most serious side effects (not common, but sometimes fatal):
GI PERFORATION
Chemo
Chemo
Chemo
Alone
Alone
Alone
A hole that develops in your stomach or intestine. Symptoms include
FATIGUE
88
FATIGUE
FATIGUE
8
pain in your abdomen, nausea, vomiting, constipation, or
fever.
%%
%
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.
WOUNDS THAT DON’T HEAL
WEAKNESS
WEAKNESS
WEAKNESS
%%
7
77%
A 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
TOO
TOO MUCH
MUCH PROTEIN
PROTEIN
TOO
MUCH
PROTEIN
00
0
IN
THE
URINE
and until surgical wounds are fully healed.
IN THE
THE URINE
URINE
IN
%%
%
SERIOUS BLEEDING
HIGH
BLOOD
PRESSURE
HIGH BLOOD
BLOOD PRESSURE
PRESSURE
HIGH
%%
1
11%
This includes vomiting or coughing up blood; bleeding in the stomach,
brain, or spinal cord; nosebleeds; and vaginal bleeding. If you recently
BLEEDING*
0.3
BLEEDING*
0.3
0.3
coughed up blood or had serious bleeding, be sure toBLEEDING*
tell your doctor.
%
%%
+
Avastin
++Avastin
Avastin
13
13
%
%%
1
Be informed. Read the Avastin treatment brochure with your family member
2
Understand your role. This brochure offers suggestions for ways you can support
3
Talk to the person you care for. Let them know how you are going to help.
10
10
%%
%
77
%%
%
66
%
%%
33
%%
%
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.
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.
Remember that honest communication is the key.
The information in this brochure should not replace the advice of your doctor.
2
Please see pages 10-13 and accompanying full Product Information, including
Serious Side Effects, for additional important safety information.
3
CAREGIVING ESSENTIALS
Taking care of yourself
Communication is key
Your 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.
Metastatic 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:
Keep yourself from feeling overwhelmed by following these tips:
Exercise, eat right, and
get enough sleep
Know your limits
Find time to relax
Ask for help
Have regular checkups
with your doctor
Join a support group or
talk to a counselor
•A
sk if it’s a good time to talk
• Speak from the heart
• Be supportive, listen, and don’t interrupt
• Remember that you can have more than one talk
• Practice what you’ll say in advance
• Don’t always say “It’ll be okay”
DEBORAH
WIFE, MOTHER,
CAREGIVER
Talking with children
It 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.
For more caregiver tips and information on support groups,
ask your doctor or nurse and visit www.Avastin.com
4
Please see pages 2, 10-13, and accompanying full Product Information, including
Serious Side Effects, for additional important safety information.
5
Caregivers
A
STORY
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.
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.
Deborah
WIFE, MOTHER, CAREGIVER
“
SHE’S BEEN
MY ROCK
“
We definitely try to spend a lot of time together. We go camping as a family, and
Life .
THROUGH CANCER AND
FOLLOWING THE TREATMENT
Your role on the health care team
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.
Taking Avastin as scheduled
Help the person you care for make all of their scheduled infusions. Avastin is given:
Every
2
weeks
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
Please see pages 2, 10-13, and accompanying full Product Information, including
Serious Side Effects, for additional important safety information.
Every
3
weeks
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
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.
How long to stay on Avastin therapy
Chemo/interferon alfa*
Avastin
8
PLAN
The person you care for should still take Avastin
as long as the disease is controlled and
side effects are manageable.
*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.
9
+ WEAKNESS
Avastin
137
13PROTEIN
TOO MUCH
WEAKNESS
7% URINE
IN THE
100
Alone
FATIGUE
OTHER POSSIBLE SERIOUS
SIDE EFFECTS
% = Percentage of patients who had this side effect in clinical studies
Chemo
Alone
SEVERE STROKE OR
HEART PROBLEMS
Across different cancers
UP TO
18
%
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.
10
7
%WEAKNESS
These may include% blood clots,
13
WEAKNESS
8%
%
3
7%
%
TOO MUCH PROTEIN
10
IN THE URINE
%
TOO MUCH PROTEIN
%
BLOOD PRESSURE
0HIGH
7%
IN THE INFUSION
URINEREACTIONS
KIDNEY PROBLEMS
These may be caused by too much protein
in the urine and can sometimes be fatal.
These 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.
HIGH BLOOD PRESSURE
BLEEDING*
1
0.3%
FATIGUE
+ Avastin
FATIGUE
8 attack, and chestWEAKNESS
mini-stroke, heart
13
+ Avastin
pain. These can sometimes be fatal.
Chemo
Alone
FATIGUE
FATIGUE
Chemo
Alone
3
TOO MUCH PROTEIN
%
7%
10
IN THE
URINE
2.6
1%
WEAKNESS
13
TOO MUCH 7PROTEIN
8%
2
7
BLEEDING*
%
6
%
%%
10
HIGH BLOOD PRESSURE
%
%
%
71
NERVOUS SYSTEM AND
Specific to advanced cervical cancer
VISION PROBLEMS
TOO MUCH PROTEIN
IN THE URINE
%
%
10.6
%
%
%
BLOOD 7
PRESSURE
0HIGH
Up to
8.3
1%
0
0.5%
0.3%
BLEEDING*
6%
3
% %
%
%
0 % CLOT IN THEBLEEDING*
HIGH
BLOOD
PRESSURE
A BLOOD
VEINS
IN10
THE
URINE
17
7
% headache, seizure,
Signs include
high blood pressure, sluggishness,
confusion, and blindness.
%
%
%
HIGH
%
% BLOOD PRESSURE
0
8%
%%
60.3
%
%
This may lead to mini-stroke, heart attack, and chest pain,
which could be fatal.
6
%%
ABNORMAL
IN THE
BODY
BLEEDING*
1 % PASSAGE0.3
3
%
This 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
0.3
3
%
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.
BLEEDING*
6
%
%
+ Avastin
8%
0.3%
3
%
Please see pages 2, 12-13, and accompanying full Product Information, including
Serious Side Effects, for additional important safety information.
11
Most common side effects
Avastin is not for everyone
In clinical studies across different types of cancers, some patients experienced the following side effects:
• 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
UNDERGOING SURGERY
Avastin should not be used for 28 days before or after surgery and until surgical wounds are fully healed.
PREGNANT
Data 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 PREGNANT
Chemo
Alone
+ Avastin
If you have any questions about your condition or treatment, talk to your doctor.
FATIGUE
8%
13%
WEAKNESS
12
Talk to your doctor if you are:
7%
10
%
Please see pages 2, 10-11, and accompanying full Product Information, including
Serious Side Effects, for additional important safety information.
TOO MUCH PROTEIN
0
%
7
%
Taking Avastin could cause a woman’s ovaries to stop working and may impair her ability to have children.
BREASTFEEDING
Breastfeeding while on Avastin may harm your baby and is therefore not recommended.
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.
13
Additional resources
Notes:
If 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)
VISIT WWW.AVASTIN.COM
Call 1-877-4AVASTIN (1-877-428-2784) for support 7 days a week
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
Genentech USA, Inc. is not affiliated with these organizations. 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.
14
Please see pages 2, 10-13, and accompanying full Product Information, including
Serious Side Effects, for additional important safety information.
BEEN RIGHT THERE
“ SHE’S
TO SUPPORT ME EVERY
STEP OF THE WAY.”
VAN, HUSBAND, FATHER, HANDYMAN
© 2015 Genentech USA, Inc., South San Francisco, CA. All rights reserved. August 2015 AVP/111914/0021a(1)