Review of bevacizumab in the treatment of metastatic breast cancer

Vascular endothelial growth factor (VEGF) inhibition is a rational therapeutic approach in breast cancer because VEGF plays an important role in tumour blood vessel growth, tumour progression and metastasis. Bevacizumab is a recombinant humanised antibody targeted at VEGF. As VEGF is overexpressed in early tumour development, there is a strong rationale for studies using bevacizumab in a first-line setting. The €2100 trial demonstrated significantly greater progression-free survival and overall response rates with a bevacizumab plus paclitaxel combination compared with paclitaxel alone as first-line therapy in previously untreated metastatic breast cancer patients. Other studies in heavily pretreated patients have shown that bevacizumab in combination with capecitabine confers varying survival benefits, which might be due to the decreased significance of VEGF in advanced stages of tumour development.