Primary systemic therapy on local advance breast cancer, where are we going?

Preoperative chemotherapy for operable breast cancer has been evaluated in a number of series. The recombinant humanized anti-human VEGF monoclonal antibody (rhuMAb, bevacizumab) inhibits several activities of VEGF, including endothelial cell growth, vascular permeability and angiogenesis. Synergy with many cancer chemotherapeutic agents, was observed in preclinical studies and in phase I and phase II trials and confirmed in phase III trials. Bevacizumab has also been tested in breast cancer in the neoadjuvant setting with encouraging results. Based on the synergism of bevacizumab in combination with chemotherapy, we will investigate the efficacy of bevacizumab in modulating the proliferation rate of locally advanced operable breast tumors treated with primary therapy.