Bevacizumab with FIRST LINE fluoropyrimidine-based chemotherapy [BEV11]

For metastatic or locally advanced and inoperable colorectal cancer where the following criteria have been met:

1. This application for bevacizumab is being made by, and the first cycle of systemic anti-cancer therapy will be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy.
2. The patient has either metastatic or locally advanced and inoperable colorectal carcinoma and has not received any previous systemic therapy for this indication.

Note

Note: patients may have received neoadjuvant systemic therapy for non-metastatic disease and/or adjuvant chemotherapy after surgery.

3. The patient’s tumour has a documented presence of microsatellite stability (MSI-S) or DNA mismatch repair proficiency (pMMR) confirmed by validated testing, OR immunotherapy is not being used as first line therapy due to its unsuitability for this patient

• patient has MSI-S/pMMR tumour
• immunotherapy (e.g. ipilimumab/nivolumab/pembrolizumab) is not suitable for this patient

4. The primary reason for the patient NOT receiving either cetuximab or panitumumab alongside first line chemotherapy is as below

• the patient has a right sided primary tumour
• the patient’s tumour has a mutant RAS status
• the RAS test result not yet reported and the decision to proceed without knowing RAS status has been discussed with the patient during the consenting process
• Cetuximab or Panitumumab are not suitable for this patient due to pre-existing medical conditions or sensitivities

5. The patient will receive fluoropyrimidine based chemotherapy alongside bevacizumab as shown below

• the patient will receive irinotecan plus infusional 5FU (FOLFIRI)
• the patient will receive oxaliplatin plus infusional 5FU (FOLFOX)
• the patient will receive irinotecan, oxaliplatin, and fluoropyrimidine chemotherapy (e.g. FOLFOXIRI)
• the patient will receive single agent capecitabine or single agent infusional 5FU
• the patient will receive an alternative fluoropyrimidine based chemotherapy regimen

6. Bevacizumab will be stopped on disease progression or unacceptable toxicity or withdrawal of patient consent whichever occurs first. Note – Patients who move to 2nd line fluoropyrimidine based chemotherapy may continue to receive bevacizumab with this 2nd line chemotherapy via form BEV12
7. When a treatment break of more than 6 weeks beyond the expected 2, or 3 - weekly cycle length is needed, a treatment break approval form will be completed to restart treatment. This MUST be approved before treatment is re- started.
8. Bevacizumab will be otherwise used as set out in its Summary of Product Characteristics (SPC).

NHS funded From: 24 December 2025

Additional information

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Note

The data on this page was produced using version 1.381 of the CDF list, downloaded from NHS England’s website on 08 January 2026 at 14:00.

If NHS England has published a new version of the CDF List but this site has not yet accessed that, this form may be out of date. Additionally, if any update has occurred without NHS England noting it as a change, this page will be out of date.

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