Skip to main content
SpringerLink
Log in

Bevacizumab

In First-Line Treatment of Metastatic Breast Cancer

  • Adis Drug Profile
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

  • ▲ Bevacizumab, a recombinant humanised monoclonal antibody against vascular endothelial growth factor, is approved in Europe as first-line therapy for metastatic breast cancer (mBC) and metastatic carcinoma of the colon or rectum (mCRC); the European Medicines Agency gave a positive opinion recommending its use in non-small-cell lung cancer (NSCLC) and is also considering other indications. In the US, it is licensed for use for mCRC and NSCLC, with its use as first-line treatment in mBC under review by the US FDA.

  • ▲ In the pivotal E2100 trial in >700 previously untreated patients with locally recurrent or mBC, recipients of bevacizumab plus paclitaxel had a statistically and clinically significant increase in progression-free survival versus paclitaxel recipients (13.3 vs 6.7 months; hazard ratio 0.48; p < 0.001) [primary endpoint].

  • ▲ There was also a >2-fold higher objective response rate in the bevacizumab plus paclitaxel arm than in the paclitaxel arm; the between-group difference in median overall survival did not reach statistical significance (25.7 vs 23.8 months).

  • ▲ Bevacizumab had an acceptable tolerability profile in these patients, with the majority of adverse events being generally mild to moderate in severity. There are targeted adverse events, including gastrointestinal perforations, wound healing complications and haemorrhage, which although they occur infrequently (incidence ≤2%), are potentially life-threatening and may cause morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. World Health Organization. The World Health Report 2002: reducing risks, promoting healthy life [online]. Available from URL: http://www.who.int/whr/2002/en/index.html [Accessed 2006 Aug 22]

  2. American Cancer Society. Breast cancer facts and figures 2005–2006 [online]. Available from URL: http://www.cancer.org/downloads/STT/CAFF2005BrF.pdf [Accessed 2006 Aug 22]

  3. Puglisi F, Cardoso F, Lebrun F, et al. First-line treatment of metastatic breast cancer: available evidence and current recommendations. Am J Cancer 2006; 5(2): 99–110

    Article  CAS  Google Scholar 

  4. Ross JS, Schenkein DP, Pietrusko R, et al. Targeted therapies for cancer 2004. Am J Clin Pathol 2004 Oct; 122(4): 598–609

    Article  PubMed  CAS  Google Scholar 

  5. Ferrara N. Vascular endothelial growth factor: basic science and clinical progress. Endocr Rev 2004 Aug; 25(4): 581–611

    Article  PubMed  CAS  Google Scholar 

  6. Yarden Y, Baselga J, Miles D. Molecular approach to breast cancer treatment. Semin Oncol 2004; 31 Suppl. 10: 6–13

    Article  PubMed  CAS  Google Scholar 

  7. Lee JS, Kim HS, Jung JJ, et al. Expression of vascular endothelial growth factor in invasive ductal carcinoma of the breast and the relation to angiogenesis and p53 and HER-2/neu protein expression. Appl Immunohistochem Mol Morphol 2002 Dec; 10(4): 289–95

    Article  PubMed  CAS  Google Scholar 

  8. Genentech Inc. Avastin™ (bevacizumab): prescribing information [online]. Available from URL: http://www.gene.com [Accessed 2007 Jul 4]

  9. European Medicines Evaluation Agency. Avastin: annex I summary of product characteristics [online]. Available from URL: http://www.emea.europa.eu [Accessed 2007 Jul 7]

  10. Lyseng-Williamson KA, Robinson DM. Bevacizumab: a review of its use in advanced colorectal cancer, breast cancer, and NSCLC. Am J Cancer 2006; 5(1): 43–60

    Article  CAS  Google Scholar 

  11. Presta LG, Chen H, O’Connor SJ, et al. Humanization of an anti-vascular endothelial growth factor monoclonal antibody for the therapy of solid tumors and other disorders. Cancer Res 1997 Oct 15; 57(20): 4593–9

    PubMed  CAS  Google Scholar 

  12. Harris M. Monoclonal antibodies as therapeutic agents for cancer. Lancet Oncol 2004 May; 5(5): 292–302

    Article  PubMed  CAS  Google Scholar 

  13. Wang Y, Fei D, Vanderlaan M, et al. Biological activity of bevacizumab, a humanized anti-VEGF antibody in vitro. Angiogenesis 2004; 7(4): 335–45

    Article  PubMed  CAS  Google Scholar 

  14. Wildiers H, Guetens G, De Boeck G, et al. Effect of antivascular endothelial growth factor treatment on the intratumoral uptake of CPT-11. Br J Cancer 2003; 88: 1979–86

    Article  PubMed  CAS  Google Scholar 

  15. Gordon MS, Margolin K, Talpaz M, et al. Phase I safety and pharmacokinetic study of recombinant human anti-vascular endothelial growth factor in patients with advanced cancer. J Clin Oncol 2001 Feb 1; 19(3): 843–50

    PubMed  CAS  Google Scholar 

  16. Hsei V, Deguzman GG, Nixon A, et al. Complexation of VEGF with bevacizumab decreases VEGF clearance in rats. Pharm Res 2002; 19(11): 1753–6

    Article  PubMed  CAS  Google Scholar 

  17. Margolin K, Gordon MS, Holmgren E, et al. Phase Ib trial of intravenous recombinant humanized monoclonal antibody to vascular endothelial growth factor in combination with chemotherapy in patients with advanced cancer: pharmacologie and long-term safety data. J Clin Oncol 2001 Feb 1; 19(3): 851–6

    PubMed  CAS  Google Scholar 

  18. Kim KJ, Li B, Winer J, et al. Inhibition of vascular endothelial growth factor-induced angiogenesis suppresses tumor growth in vivo. Nature 1993 Apr 29; 362: 841–4

    Article  PubMed  CAS  Google Scholar 

  19. Wedam SB, Low JA, Yang SX, et al. Antiangiogenic and antitumor effects of bevacizumab in inflammatory and locally advanced breast cancer patients. J Clin Oncol 2006; 24(5): 769–77

    Article  PubMed  CAS  Google Scholar 

  20. Mahmood I. Center for Drug Evaluation and Research. Approval package for: application number STN-125085/0-clinical pharmacology/TOX review [online]. Available from URL: http://www.accessdata.fda.gov/scripts/cder/drugsatfda/ [Accessed 2005 Nov 28]

  21. Miller KD. E2100: a phase III trial of paclitaxel versus paclitaxel/bevacizumab for metastatic breast cancer. Clin Breast Cancer 2003; 3(6): 421–2

    Article  PubMed  CAS  Google Scholar 

  22. Zon R, Miller K, Wang M, et al. A randomized phase III trial of paclitaxel with or without bevacizumab as first-line therapy for locally recurrent or metastatic breast cancer: Eastern Cooperative Oncology Group trial E2100 [abstract no. 7]. Eur J Cancer Suppl 2006 Mar; 4(2): 47

    Article  Google Scholar 

  23. European Medicines Agency. Extension of the indication to include Avastin in combination with paclitaxel for first-line treatment of patients with metastatic breast cancer: scientific discussion [online]. Available from URL: http://www.emea.eu [Accessed 2007 May 1]

  24. Hoffmann La-Roche Ltd., Avastin plus paclitaxel: higher quality of life score vs paclitaxel alone. Basel: Hoffmann La-Roche Ltd., 2007. (Data on file)

  25. Beaulieu D. EU panel issue positive opinion for Avastin in NSCLC [online]. Available from URL: http://www.firstword-plus.com [Accessed 2007 Jul 23]

  26. Hoffmann-La Roche Ltd. Avastin filed with FDA in US for treatment of women with advanced breast cancer [online]. Available from URL: http://www.roche.com [Accessed 2006 Aug 29]

Download references

Author information

Authors and Affiliations

  1. Wolters Kluwer Health ¦ Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, Auckland, 0754, New Zealand

    Lesley J. Scott

  2. Wolters Kluwer Health, Conshohocken, Pennsylvania, USA

    Lesley J. Scott

Authors
  1. Lesley J. Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lesley J. Scott.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scott, L.J. Bevacizumab. Drugs 67, 1793–1799 (2007). https://doi.org/10.2165/00003495-200767120-00009

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200767120-00009

Keywords

Search

Navigation