Bevacizumab in the management of colorectal cancer: A review

Background

Since its approval in 2004 for the treatment of metastatic colorectal cancer (mCRC), multiple studies have been conducted with the objective of better defining the use of bevacizumab within and beyond the metastatic setting. This review aims to summarize the data on the clinical applications and nuances of bevacizumab in the management of CRC. 

Principal Findings

Bevacizumab can prolong survival in patients with metastatic disease, but is not beneficial in the adjuvant setting.  Bevacizumab may be considered as part of peri-operative treatment for carefully selected patients undergoing resection of liver metastases.  Bevacizumab added to neoadjuvant chemoradiation for localized rectal cancer demonstrates promising activity and safety, but this is investigational.

Conclusions/Significance

The decision to use bevacizumab in the management of CRC requires careful consideration of the patient and clinical context.  Given the cost as well as toxicities of bevacizumab, it is important for oncologists to know how to use this drug judiciously in order to ensure patient safety and quality of life in addition to improving survival.