Evidence for the role of bevacizumab in the treatment of advanced metastatic breast cancer: a review.

Angiogenesis inhibitors may provide a new approach to the treatment of metastatic breast cancer. Bevacizumab is a monoclonal antibody against pathologic angiogenesis. A pivotal study (ECOG 2100) showed that bevacizumab in combination with paclitaxel increased progression-free survival for patients with metastatic breast cancer by 6 months. Subsequently, several clinical trials have shown that the combination of bevacizumab with a taxane can improve disease-free survival but does not prolong overall survival. While generally well tolerated, bevacizumab is potentially toxic for some patients who develop hypertension, proteinuria, bleeding, impaired wound healing, bowel perforation or thromboembolic events. Here, we review the current evidence for the use of bevacizumab in breast cancer and ongoing studies that address the questions of how to optimize regimens and schedules for the use of anti-angiogenic agents and the identification of those patients who would benefit the most from treatment with regimens that include antiangiogenic therapy.