NCCN Guidelines for Patients
Colon Cancer, Version 1.2017
Cancer cells need the food and oxygen in blood to
grow. Cancer cells get blood from blood vessels
that have grown into the tumor. VEGF is one of the
molecules that triggers the growth of these blood
VEGF is made by cancer cells. It travels from cancer
cells to endothelial cells. Endothelial cells form blood
Surface receptors are proteins within cell membranes
that extend from the inside to the outside of cells.
VEGF attaches to surface receptors on the outside
of endothelial cells. Attachment of VEGF to receptors
triggers growth signals. There are four medicines
used to stop the growth signals caused by VEGF.
Bevacizumab attaches to VEGF before it attaches to
receptors on endothelial cells.
See Figure 11
a result, VEGF can’t attach to receptors. No growth
signals caused by VEGF are started.
Bevacizumab is given by infusion. It takes about
90 minutes to get the first dose and 30 minutes
for later doses. Bevacizumab is always given with
chemotherapy. It is given every two or three weeks
depending on the chemotherapy.
Common side effects of bevacizumab are high blood
pressure, diarrhea, and feeling tired and weak. You
might also have nosebleeds, shortness of breath,
nausea, and vomiting. Rare but serious side effects
include stroke, heart attack, kidney damage, holes in
the intestine, and bleeding within the body.
Overview of cancer treatments
VEGF targeted therapy
Cancer cells need blood to grow.
They send VEGF to endothelial
cells to start the growth of blood
vessels. Regorafenib stops
growth signals within endothelial
cells. Ramucirumab blocks VEGF
from attaching to receptors. Ziv-
aflibercept traps VEGF by being
a receptor decoy. Bevacizumab
disables VEGF from attaching to
Copyright © 2017 National Comprehensive Cancer Network