Overview | Schedule | Side Effects | Monitoring | Tips | Patient Assistance | Emotional Wellness | Drugs | References
Treatment Name: BCP (Bevacizumab + Carboplatin + Paclitaxel)
How does BCP (Bevacizumab + Carboplatin + Paclitaxel) work?
Both carboplatin and paclitaxel are chemotherapy drugs designed to kill and slow the growth of cancer cells.
Bevacizumab is a drug designed to slow the growth of cancer cells by decreasing the spread of blood vessels carrying nutrients to cancer cells.
B – Bevacizumab
C – Carboplatin
P – Paclitaxel (Taxol®)
Goals of therapy:
BCP is given as a first-line treatment to patients with advanced or metastatic NSCLC. BCP may help relieve symptoms of lung cancer and slow the progression of lung cancer, but it is not commonly given with the goal of cure.
How is BCP therapy for NSCLC given?
- Bevacizumab intravenous (I.V.) infusion over 90 minutes on Day 1 of Cycle 1
- Then over 60 minutes for Cycle 2, if no infusion reactions occur
- Then over 30 minutes for Cycles 3 and on, if no infusion reactions occur
- Carboplatin I.V. infusion over 30 minutes on Day 1
- Paclitaxel I.V. infusion over 3 hours on Day 1
Estimated total infusion time for this treatment:
- Up to 6 hours for Cycle 1, Day 1; as short as 5 for the first day of next cycles if well tolerated
- Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time
BCP is usually given in an outpatient infusion center, allowing the person to go home afterwards. On occasion, it may be given in the hospital if someone is too sick.
BCP is repeated every 21 days. This is known as one Cycle. Each cycle may be repeated up to 6 times, depending upon the stage of the disease. Duration of therapy may last up to 5 months, depending upon response, tolerability, and number of cycles prescribed.
Click here for the common BCP starting doses.
What are the most common side effects from BCP for NSCLC?
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported side effects of BCP are shown here. Side effects sometimes have percentage ranges [example: 6 – 18%] because they differed between clinical studies:
- Nausea (50%)
- Headache (3-47%)
- Nose bleed (44%)
- Diarrhea (42%)
- Rash (24%)
- Low white blood cells [Neutropenia] (26%)
- Vomiting (23%)
- Low platelets [Thrombocytopenia] (21%)
- Fatigue (16%)
- High blood pressure (6-18%)
- Tingling or numbness in fingers or toes (15%)
- Neutropenic fever (4-5%)
- Protein in urine (3%)
- Hair Loss (exact percentage not reported in clinical trials)
- Anemia (exact percentage not reported in clinical trials)
Importantly, not all people who experience a side effect from BCP will experience it in the same way. It may be mild in some or severe in others, depending upon the individual. Everybody is different. Additionally, side effects may vary over time. For some, side effects may be a reason to delay or switch treatment, reduce the dose, or avoid treatment with a certain medication altogether.
Side effects may be treatable when they occur or preventable by taking certain medications before they happen. When medications are taken to prevent a problem, this is known as prophylaxis, or "prophy" for short.
After starting treatment with BCP, be sure to come back and watch all of the side effect videos shown below. Each of these videos contain valuable information about side effect management that will hopefully help you to both feel better and stay out of the hospital.
Watch videos on common BCP therapy side effects below
How often is monitoring needed?
Labs (blood tests) may be checked before each treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), urine protein levels, plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment and during cancer treatment if there are concerns for disease progression or side effects. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue BCP as planned, reduce the dose of future treatments, delay the next dose until the side effect goes away, or switch to an alternative therapy.
Questions to Ask Your...
A better understanding of your treatments will allow you to ask more questions of your healthcare team. We then hope that with the answers, you will get better results and have greater satisfaction with your care. Because we know it's not always easy to know what questions to ask, we've tried to make it easy for you!
Choose any healthcare provider below to see common questions that you may want to ask of this person. Then, either print each list to bring to your clinic visits, or copy the questions and send them as a message to your healthcare team through your electronic medical record.
What are the most important things to know about BCP while receiving therapy?
- Bevacizumab may lead to increases in blood pressure after starting therapy. If you currently are taking medications to control blood pressure, the doses of these medications may need to be adjusted or you may need to take additional medications to help control blood pressure
- Tell your doctor if you plan on having any surgeries while on therapy with bevacizumab as it can delay wound healing from the surgery and possibly lead to complications
- Paclitaxel tends to cause infusion reactions that can be related to the cremophor that is used in the IV formulation. Patients may receive several medications prior to receiving paclitaxel (this is known as "premedication") to decrease the risk of infusion reactions. Common pre-medications given are a histamine-2 blockers such as famotidine (Pepcid®) or ranitidine (Zantac®), a histamine-1 blocker such as diphenhydramine (Benadryl®), and a corticosteroid such as dexamethasone
- Carboplatin hypersensitivity reaction can be severe. This reaction is most common after the 6th cycle, but can happen after any dose. Some institutions may use "desensitization protocols" to allow a person to keep receiving carboplatin after they have had a reaction. Desensitization is used if someone is receiving a good response from carboplatin, or if few other chemotherapy options are available
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for NSCLC. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications.
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for BCP (Bevacizumab + Carboplatin + Paclitaxel), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for BCP (Bevacizumab + Carboplatin + Paclitaxel). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as BCP (Bevacizumab + Carboplatin + Paclitaxel) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with BCP (Bevacizumab + Carboplatin + Paclitaxel)