Bevacizumab in the treatment of metastatic breast cancer: friend or foe?
Metastatic breast cancer (MBC) is a major cause of death among women worldwide. Progress has been made in treating MBC with the advent of anti-estrogen therapies, potent cytotoxic agents, and monoclonal antibodies. Bevacizumab is a monoclonal antibody against circulating vascular endothelial growth factor (VEGF), which was approved in 2008 by the US Food and Drug Administration (FDA), for first-line treatment of HER-2 negative MBC in combination with paclitaxel. The FDA then reversed this decision in December 2010 by recommending removal of the MBC indication from bevacizumab, citing primarily safety concerns, and that these risks did not outweigh the ability of bevacizumab to significantly prolong progression-free survival. This decision was unexpected in the oncology community and remains controversial. This review looks at all available phase 3 data with bevacizumab in the MBC setting to determine whether the data support this decision by the FDA, and discusses the future of bevacizumab in breast cancer.
UM/Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA. AMontero2@med.miami.edu
Alberto J
AJ
Montero
Mauricio
M
Escobar
Gilberto
G
Lopes
Stefan
S
Glück
Charles
C
Vogel
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000098:blood supply / Q000188:drug therapy*; D017326:Clinical Trials, Phase III as Topic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab