Roche analyzed three bogus vials of Avastin and found they contained salt, starch, citrate, isopropanol, propanediol, t-butanol, benzoic acid, di-fluorinated benzene ring, acetone and phthalate moiety, but no active ingredients of the cancer drug. According to Roche, the levels of the chemicals were not consistent; whether the chemicals were at harmful concentrations could not therefore be determined. The counterfeit Avastin has been traced back to Egypt, and it entered legitimate supply chains via Europe to the United States. Biosimilars
In July 2014, two pharming companies, PlantForm and PharmaPraxis, announced plans to commercialize a biosimilar version of bevacizumab made using a tobacco expression system in collaboration with the Fraunhofer Center for Molecular Biology.In September 2017, the US FDA approved Amgens biosimilar (generic name bevacizumab-awwb, product name Mvasi) for six cancer indications.In January 2018, Mvasi was approved for use in the European Union.In February 2019, Zirabev was approved for use in the European Union.
A chest X-ray can show abnormalities anywhere, but the most specific finding is increased shadow in the periphery of the lungs, away from the heart. Differential diagnosis
This includes:

Asthma
Environmental allergic reaction
Granulomatosis with polyangiitis
Allergic bronchopulmonary aspergillosis
Churg–Strauss syndrome
Loefflers syndrome
Acute eosinophilic pneumonia
Chronic eosinophilic pneumonia (Carringtons disease)
Polyarteritis nodosa
Parasitic infections
Tropical pulmonary eosinophilia
Tuberculosis
Fungal infection
Sarcoidosis
Drug reaction with eosinophilia and systemic symptoms
Mastocytosis
Lymphoproliferative hypereosinophilic syndrome
Myeloproliferative hypereosinophilic syndrome

Treatment
When eosinophilic pneumonia is related to an illness such as cancer or parasitic infection, treatment of the underlying cause is effective in resolving the lung disease. When due to acute or chronic eosinophilic pneumonia, however, treatment with corticosteroids results in a rapid, dramatic resolution of symptoms over the course of one or two days. Either intravenous methylprednisolone or oral prednisone are most commonly used. In acute eosinophilic pneumonia, treatment is usually continued for a month after symptoms disappear and the X-ray returns to normal (usually four weeks total). In chronic eosinophilic pneumonia, treatment is usually continued for three months after symptoms disappear and the X-ray returns to normal (usually four months total). Inhaled steroids such as fluticasone have been used effectively when discontinuation of oral prednisone has resulted in relapse. Because eosinophilic pneumonia affects the lungs, individuals develop difficulty breathing. If enough of the lungs are involved, it may not be possible for a person to breathe without support. Non-invasive machines such as a bilevel positive airway pressure machine may be used. Otherwise, placement of a breathing tube into the mouth may be necessary and a ventilator may be used to help the person breathe.