title: Use of bevacizumab as a first-line treatment for metastatic breast cancer.
abstract: OBJECTIVE
  During clinical practice, it can be challenging, given the lack of response biomarkers, to identify the patients with metastatic breast cancer (mbca) who would benefit most from the addition of bevacizumab to first-line standard chemotherapy. The aim of the present review was to summarize the relevant scientific evidence and to discuss the experience of a group of experts in using bevacizumab to treat mbca.
  
  
  METHODS
  A panel of 17 Spanish oncology experts met to discuss the literature and their experience in the use of bevacizumab as first-line treatment for mbca. During the meeting, discussions focused on three main issues: the profile of the patients who could benefit most from bevacizumab, the optimal bevacizumab treatment duration, and the safety profile of bevacizumab.
  
  
  RESULTS
  The subset of mbca patients who would benefit the most from the addition of bevacizumab to first-line standard chemotherapy are those with clinically defined aggressive disease. Treatment with bevacizumab should be maintained until disease progression or the appearance of unacceptable toxicity. In the mbca setting, the toxicity profile of bevacizumab is well known and can be managed in clinical practice after adequate training.
  
  
  CONCLUSIONS
  This expert group recommends administering bevacizumab as first-line treatment in patients with clinically aggressive disease.
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Manso
authors.affiliation: Hospital Universitario Clínico San Carlos, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Moreno
authors.affiliation: MD Anderson Cancer Center, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Márquez
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Castelo
authors.affiliation: Hospital General Universitario de Guadalajara, Guadalajara, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Arcediano
authors.affiliation: Hospital Príncipe de Asturias, Alcalá de Henares, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Arroyo
authors.affiliation: Hospital de la Princesa, Madrid, Spain.
authors.forename: A I
authors.initials: AI
authors.lastname: Ballesteros
authors.affiliation: Centro Integral Oncológico Clara Campal, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Calvo
authors.affiliation: Hospital Universitario Severo Ochoa, Leganés, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Echarri
authors.affiliation: Hospital Universitario de Getafe, Getafe, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Enrech
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gómez
authors.affiliation: Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: González Del Val
authors.affiliation: Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: López-Miranda
authors.affiliation: Hospital Príncipe de Asturias, Alcalá de Henares, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Martín-Angulo
authors.affiliation: Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Martínez-Jañez
authors.affiliation: Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Olier
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Zamora
keywords: Bevacizumab; clinical practice; metastatic breast cancer