According to the latest statistical reports of the World Health Organization, there are approximately 14 million cases of cancer per year globally, making cancer one of the leading causes of death worldwide (1,2). In recent years there has been a considerable increment in anticancer drugs, which are either curative or meant to prolong survival and/or improve the quality of life of the patients. Considering the significant increase in cancer patient annually, it is crucial for patients to receive the proper treatment on time. Unfortunately, the management of cancer is based on the availability and the affordability of these anticancer therapies (3).
Bevacizumab (Avastin®) is a recombinant humanized monoclonal immunoglobulin G1 antibody, that blocks the activity and angiogenesis of the human vascular endothelial growth factor A (VEGF-A). Bevacizumab, in combination with chemotherapy, is an important component for treatment of epithelial ovarian and fallopian tube cancer, metastatic colorectal cancer, non-small-cell lung cancer and metastatic renal cell cancer. However, the accessibility to bevacizumab, along with other angiogenesis inhibitors, is limited due to factors such as insurance coverage, drug
availability, supply and manufacturing costs and the lack of cost-effectiveness in some patients(4).
Bevacizumab is a biologic, a medicine whose active ingredients are created by biological processes instead of chemical synthesis. Unlike medicines that are chemically synthesized, most biologics are large structurally complex mixtures that are not easily identified and are susceptible to manufacturing conditions. As a result, biologics cannot easily be replicated (1,5). Biologics can obtain patent protection for 20 years, starting from the day the application for approval is submitted. With the patent expiry of several originator biologics, a market has opened for biosimilars. Biosimilars are medicines that are designed to be similar to their originator biologics in terms of quality, efficacy and tolerability (4,6).
Recently the Food and Drug Administration (FDA) approved Mvasi® (bevacizumab-awwb) as a biosimilar of bevacizumab for the treatment of various types of cancer (7). Biosimilars, such as Mvasi®, can potentially increase patients’ accessibility to an affordable alternative anti-cancer therapy and as a result improve clinical outcomes. Furthermore, biosimilars may provide additional treatment options for patients and physicians and potentially optimize efficiencies across healthcare systems worldwide (4).
The impact of biosimilars in the treatment of cancer has been a subject of discussion between oncologist and hematologists, as well as patients seeking for more affordable therapies (1). As biosimilars are a fairly new treatment option, there are still some uncertainties and concerns about these drugs. This review discusses the differences and similarities between Avastin® and Mvasi®, in terms of mechanism of action, manufacturing, approval process and the advantages and disadvantages including the economic implications.