Purpose of review: Drugs targeting angiogenesis are rapidly being incorporated into cancer treatment regimens. Bevacizumab was the first antiangiogenesis agent to gain approval by the Food and Drug Administration and is now approved for use in five tumor types. This brief review highlights important recent advances in our understanding of bevacizumab and the patient populations in whom it may be most beneficial.
Recent findings: Results from early studies that led to approval of bevacizumab for use in metastatic colorectal cancer and metastatic lung cancer have been confirmed. Although bevacizumab does not appear to prolong disease-free survival in the adjuvant treatment of colorectal cancer, phase II results in the neoadjuvant treatment of colorectal cancer and breast cancer are encouraging. It may also have a role in maintenance therapy of colorectal cancer and nonsmall cell lung cancer. Bevacizumab is an important agent in the treatment of recurrent glioma. Although the safety profile of bevacizumab in combination with cytotoxic agents has not changed significantly, there may be excess risk associated with combined angiogenesis blockade.
Summary: Bevacizumab has efficacy in a wide variety of cancers and fairly predictable toxicities. In addition to further exploration of the benefits of bevacizumab in other tumor types, future research should focus on integration of biomarkers into patient selection and treatment.