title: Markers of response for the antiangiogenic agent bevacizumab.
abstract: Bevacizumab is the first antiangiogenic therapy proven to slow metastatic disease progression in patients with cancer. Although it has changed clinical practice, some patients do not respond or gradually develop resistance, resulting in rather modest gains in terms of overall survival. A major challenge is to develop robust biomarkers that can guide selection of patients for whom bevacizumab therapy is most beneficial. Here, we discuss recent progress in finding such markers, including the first results from randomized phase III clinical trials evaluating the efficacy of bevacizumab in combination with comprehensive biomarker analyses. In particular, these studies suggest that circulating levels of short vascular endothelial growth factor A (VEGF-A) isoforms, expression of neuropilin-1 and VEGF receptor 1 in tumors or plasma, and genetic variants in VEGFA or its receptors are strong biomarker candidates. The current challenge is to expand this first set of markers and to validate it and implement it into clinical practice. A first prospective biomarker study known as MERiDiAN, which will treat patients stratified for circulating levels of short VEGF-A isoforms with bevacizumab and paclitaxel, is planned and will hopefully provide us with new directions on how to treat patients more efficiently.
authors: Vesalius Research Center, VIB, Herestraat 49, bus 912, Leuven, Belgium. diether.lambrechts@vib-kuleuven.be
authors: Diether
authors: D
authors: Lambrechts
authors: Heinz-Josef
authors: HJ
authors: Lenz
authors: Sanne
authors: S
authors: de Haas
authors: Peter
authors: P
authors: Carmeliet
authors: Stefan J
authors: SJ
authors: Scherer
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D015415:Biomarkers / Q000032:analysis*; D018450:Disease Progression; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D039942:Neuropilin-1 / Q000032:analysis; D020033:Protein Isoforms / Q000032:analysis; D016032:Randomized Controlled Trials as Topic; D040262:Receptors, Vascular Endothelial Growth Factor / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000235:genetics
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D015415:Biomarkers; D020033:Protein Isoforms; D042461:Vascular Endothelial Growth Factor A; D039942:Neuropilin-1; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor