Our Therapies

ALYMSYS® Infusion Therapy

Next-generation infusion care - Violet Health Infusion Care

About ALYMSYS® Infusion Therapy

ALYMSYS® (bevacizumab-maly) is a biologic medication known as a VEGF inhibitor, given as an intravenous (IV) infusion. It is a biosimilar to AVASTIN® (bevacizumab), which means the FDA has determined it is highly similar to AVASTIN® with no clinically meaningful differences in safety or effectiveness. Like all bevacizumab products, ALYMSYS® targets the tumor's blood supply rather than the immune system. Vascular endothelial growth factor, or VEGF, is a signal tumors use to build new blood vessels. By binding VEGF and preventing it from reaching its receptors, ALYMSYS® helps limit the growth of those vessels, which slows the tumor's access to oxygen and nutrients. This is called anti-angiogenic therapy.

All ALYMSYS® dosing is weight-based, and both the dose and the interval depend on your diagnosis and the chemotherapy it is paired with. Common regimens include 5 mg/kg every two weeks, 7.5 mg/kg every three weeks, 10 mg/kg every two weeks, and 15 mg/kg every three weeks. The first infusion is given over 90 minutes. If you tolerate it well, the second is given over 60 minutes, and later infusions over 30 minutes.

ALYMSYS® is almost always given with chemotherapy or another therapy rather than on its own, and in several regimens it continues as a single agent after the chemotherapy portion is complete. Because of its effect on blood vessels and wound healing, treatment cannot begin until at least 28 days after major surgery and the surgical wound has fully healed, and it is paused at least 28 days in advance of any planned procedure.

Conditions treated by this therapy

ALYMSYS® is FDA-approved across six tumor types, nearly always in combination with chemotherapy or another therapy. Your care team may consider this therapy if you have:

Metastatic colorectal cancer, with intravenous fluorouracil-based chemotherapy, as first-line or second-line treatment
Metastatic colorectal cancer that has progressed on a first-line bevacizumab product-containing regimen, with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin chemotherapy
Unresectable, locally advanced, recurrent, or metastatic non-squamous non-small cell lung cancer, with carboplatin and paclitaxel, as first-line treatment
Recurrent glioblastoma in adults
Metastatic renal cell carcinoma (kidney cancer), with interferon alfa
Persistent, recurrent, or metastatic cervical cancer, with paclitaxel and cisplatin or paclitaxel and topotecan
Platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who have received no more than two prior chemotherapy regimens, with paclitaxel, pegylated liposomal doxorubicin, or topotecan

ALYMSYS® is approved for adults. Safety and effectiveness in patients under 18 have not been established. Two points are worth knowing: ALYMSYS® is not indicated for the adjuvant treatment of colon cancer, where bevacizumab did not improve outcomes in clinical studies, and its approved indication list is narrower than AVASTIN®. It does not currently include the stage III or IV ovarian cancer setting after initial surgery, the platinum-sensitive recurrent ovarian setting, or hepatocellular carcinoma with atezolizumab. If your regimen calls for one of those, our team will confirm with your oncologist which bevacizumab product is intended.

ALYMSYS® Price

The cost of prescription medications can vary depending on your insurance coverage. If you're concerned about the price of your medication:

Contact your insurance provider to understand your coverage
Ask your doctor or pharmacist about lower-cost alternatives
Check with the drug manufacturer about financial assistance programs
Explore patient assistance options if you're uninsured or underinsured

Remember, many resources exist to help patients access necessary medications. Don't hesitate to ask for help if you're struggling with medication costs. No patient should go without necessary treatment due to financial limitations. If you have questions about financial assistance opportunities, contact a member of our Violet Health team.

What to Expect During ALYMSYS® Infusion Therapy

When you arrive at our Violet Health location, you'll settle into a private, welcoming space designed with your comfort and peace of mind in mind. Before and during your intravenous infusion, our experienced team will:

Review your current health status and any symptoms you've noticed since your last visit, particularly bleeding, headaches, abdominal pain, or swelling
Confirm your current weight, since every ALYMSYS® dose is calculated per kilogram
Check your blood pressure, which is monitored at every visit and typically every two to three weeks throughout treatment
Review your urine protein results and recent lab work, since protein in the urine is checked regularly during ALYMSYS® therapy
Confirm that you have no recent surgery, unhealed wound, or upcoming procedure that would require pausing treatment
Place your IV using gentle, practiced technique
Administer your ALYMSYS® infusion over 90 minutes for the first dose, 60 minutes for the second if the first is well tolerated, and 30 minutes thereafter
Monitor you closely for any infusion-related reactions
Protect your privacy and comfort throughout the visit

ALYMSYS® is diluted in sodium chloride rather than dextrose, and it is given through its own line. On chemotherapy days, ALYMSYS® is generally given first, before the chemotherapy portion of the visit. In the kidney cancer regimen it is paired with interferon alfa, which you give yourself at home three times a week rather than at the infusion center. Combination days run longer than ALYMSYS®-only days, so plan for extra time at those visits.

Several regimens have two phases: ALYMSYS® with chemotherapy for a set number of cycles, then ALYMSYS® alone until disease progression or intolerance. Those single-agent visits are shorter and simpler. Blood pressure checks and urine protein testing continue throughout, and because bevacizumab stays in your system for roughly 20 days after a dose, your team will factor that into the timing of any surgery or procedure.

ALYMSYS® Side Effects

As with any medication, ALYMSYS® may cause side effects. Being informed helps you know what to watch for and when to contact your healthcare team. Common Side Effects:

High blood pressure (hypertension)
Nosebleeds (epistaxis)
Headache
Protein in the urine (proteinuria)
Runny nose or sinus congestion (rhinitis)
Change in taste, dry skin, and watery eyes
Back pain and scaling or peeling skin (exfoliative dermatitis)
Tiredness or weakness, diarrhea, decreased appetite, and weight loss

Hypertension, nosebleeds, and proteinuria are the three most characteristic bevacizumab effects, and all three are expected enough that your team monitors for them at every visit rather than waiting for symptoms. The rest of the side effect picture depends heavily on the chemotherapy partner: platinum and taxane regimens add low blood counts, neuropathy, mouth sores, and hand-foot syndrome, while the interferon alfa combination for kidney cancer adds flu-like symptoms, muscle aches, and gum bleeding.

ALYMSYS® carries serious risks that come from how it affects blood vessels and healing. These reactions can be severe or life-threatening. Please alert our clinical staff or seek medical attention immediately if you experience any of the following:

A tear in the stomach or intestine (gastrointestinal perforation) or an abnormal connection between organs (fistula), including severe abdominal pain, nausea, vomiting, constipation, or fever. These can be fatal and most often occur within the first 50 days of treatment. Report severe abdominal pain immediately
Wound healing problems, including a surgical wound that opens, drains, or does not heal. Treatment cannot start for at least 28 days after major surgery and is paused at least 28 days before any planned procedure. Do not schedule surgery, including dental surgery, without telling your care team first
Serious bleeding (hemorrhage), including coughing up blood, vomiting blood, black or tarry stools, blood in the urine, unusual vaginal bleeding, or a nosebleed that will not stop. Severe or fatal bleeding, including bleeding in the lungs, digestive tract, or brain, has been reported
Blood clots in an artery, including chest pain, sudden weakness or numbness on one side of the body, trouble speaking, or sudden vision changes. Risk is higher if you are over 65, have diabetes, or have had a clot before
Blood clots in a vein, including swelling, pain, or redness in a leg, or sudden shortness of breath and chest pain
Severe high blood pressure, including a blood pressure reading much higher than your usual, severe headache, confusion, or chest pain. Your blood pressure will be checked regularly, and you may need medication to control it
Posterior reversible encephalopathy syndrome (PRES), a rare brain condition that can cause seizures, severe headache, confusion, vision loss, or other new neurologic symptoms. It can appear anywhere from hours to a year after the first dose
Kidney injury and protein in the urine, including foamy urine, a change in how much you urinate, or swelling in the legs, ankles, or around the eyes. Severe cases can progress to nephrotic syndrome
Heart failure, including increasing shortness of breath, swelling in the legs or abdomen, or difficulty lying flat. Risk is higher if you have received anthracycline chemotherapy. ALYMSYS® is not indicated for use with anthracycline-based chemotherapy
A rapidly spreading soft tissue infection (necrotizing fasciitis), including severe pain, redness, and swelling of the skin with fever. This usually follows a wound healing complication, perforation, or fistula
Infusion reactions, including high blood pressure, wheezing, shortness of breath, chest pain, headache, chills or shaking, and sweating

Managing these reactions often means pausing or stopping treatment. There are no dose reductions for ALYMSYS®: depending on what develops, your oncologist will either hold the drug until the problem resolves or discontinue it permanently. Perforation, tracheoesophageal fistula, fistula involving any internal organ, necrotizing fasciitis, grade 3 or 4 bleeding, severe arterial clots, PRES, nephrotic syndrome, heart failure, and severe infusion reactions all call for stopping treatment.

Before treatment, tell your care team about any surgery or procedure in the last two months or planned in the coming months, including dental work, any history of bleeding, blood clots, stroke, heart attack, or heart failure, any coughing up of blood, high blood pressure or the medications you take for it, kidney problems or protein in your urine, prior pelvic radiation, and any blood thinners or antiplatelet medications you take.

Pregnancy, fertility, and lactation: ALYMSYS® may harm an unborn baby. Tell your care team if you are pregnant or plan to become pregnant. Use effective birth control during treatment and for six months after your last dose, and do not breastfeed during treatment or for six months after your last dose. ALYMSYS® also increases the risk of ovarian failure and may affect fertility. If you may want to have children in the future, talk with your care team about options for preserving eggs before you start treatment.

ALYMSYS® Infusion Therapy at Violet Health

Your comfort during ALYMSYS® infusion therapy at Violet Health is our priority. Our patients enjoy walk-up parking, complimentary entertainment and snacks, and a team of highly trained providers during each treatment. Plus, Violet Health's evening and weekend hours and convenient city and rural locations make it easier to schedule your appointments.