Bevacizumab, the “predecessor” of anti-angiogenic therapy in oncology, was approved for marketing by the FDA in 2004 s. To date, bevacizumab has been used in Europe and the United States for a variety of solid tumor indications, such as colorectal cancer, lung cancer, and kidney cancer.
Bevacizumab has been marketed in China and is not yet indicated for breast cancer, but the drug can be combined with paclitaxel or capecitabine in Europe for the treatment of metastatic breast cancer.
Hormone receptor-positive breast cancer, in which tumor development is closely linked to estrogen and progesterone, is usually treated with endocrine drugs. This article takes a quick look at how effective bevacizumab can be in these advanced patients.
How does bevacizumab work?
How does bevacizumab work?
Like normal cells, tumor cells need blood to grow and provide nutrients. And an active substance called vascular endothelial growth factor (VEGF) plays an important role in the process of blood vessel renewal in the body.
Normal cells produce only moderate amounts of VEGF, but not tumor cells, which secrete large amounts of VEGF, stimulating the surrounding blood vessels to grow wildly so they can get nutrients from the blood and even metastasize to distant sites through the blood vessels.
In response to this feature of tumors, anti VEGF has become an important therapeutic direction. Unlike chemotherapy drugs that attack tumor cells directly, anti VEGF drugs cut off the nutritional “gateway” to the tumor by blocking the overproduction of VEGF and inhibiting vascularization. The most important thing is that it is not only a good idea to have a good idea of what you are doing, but it is also a good idea to have a good idea of what you are doing.
Hormone receptor-positive advanced breast cancer: bevacizumab slows progression but increases adverse effects
As mentioned earlier, the most important treatment for hormone-receptor-positive breast cancer is endocrine therapy, and the main effect of bevacizumab is anti-angiogenesis; what can the combination of the two therapies bring to patients with advanced disease?
In a phase III clinical trial called CALGB 40503 the study was conducted in 343 postmenopausal patients with hormone receptor-positive advanced breast cancer. The addition of bevacizumab to letrozole endocrine therapy reduced the risk of progressive disease by 25% and extended median progression-free survival from 15.6 months to 20.2 months.
Unfortunately, the combination of bevacizumab did not result in longer survival for patients. Moderate adverse reactions associated with bevacizumab treatment were mainly hypertension (24%) and proteinuria (11%).
Summary
As seen above, in postmenopausal hormone receptor-positive advanced breast cancer, letrozole in combination with bevacizumab can control tumor progression but with increased adverse effects. The benefits need to be fully weighed against the risks when choosing this regimen.
More research is needed to see if bevacizumab can take its place in breast cancer. In terms of efficacy prediction, if efficacy can be clarified before dosing, treatment will be more targeted, thus providing more hope for patients.