Bevacizumab: A dose review

•Two dose-intensities are approved for bevacizumab: 2.5 mg/kg/week and 5 mg/kg/week equivalent.•There is no consensus on the optimum regimen.•Optimization of doses schemes could reduce potential dose-effect toxicities.•We reviewed the bevacizumab studies that led to its approval and discuss it with pre-clinical and further research lines.

Angiogenesis is a key process in cancer development and has been described has a hallmark of cancer. Two dose-intensities were approved for cancer treatment by the Food and Drug Administration and European Medicines Agency: 2.5 mg/kg/week dose equivalent and 5 mg/kg/week dose equivalent. While bevacizumab has shown its effectiveness in clinical trials, pharmacodynamics is not fully understood and a dose-effect relationship has not been proven in vivo. Direct trials comparing high or low doses are rare with potential dose-effect toxicity. Discordant data have been reported on the efficacy of doses. This review discusses the dose of bevacizumab via the analysis of studies that led to the approval of bevacizumab in clinical practice.Optimization of doses schemes could reduce potential dose-effect toxicities, potentiate synergetic effects with chemotherapy and permit the prescription to a larger population with a better cost-effectiveness ratio.