Bevacizumab is a humanised variant of the anti-VEGF monoclonal antibody that has been studied as an anti-angiogenic cancer therapeutic as a single agent and in combination with chemotherapy in patients with stage III and IV colon cancer. In addition to its direct anti-angiogenic effects, bevacizum-ab may allow more efficient delivery of chemotherapy by altering tumour vasculature and decreasing the elevated interstitial pressure common in tumours. Eight hundred and thirteen patients with previously untreated metastatic colorectal cancer were randomly assigned to receive IFL plus bevacizumab (5 mg/kg body weight every two weeks) or to receive IFL plus placebo. The primary end-point was overall survival. Secondary end-points were progression-free survival, response rate, duration of the response, safety and QoL. Median survival was 20.3 months for IFL plus bevacizumab and 15.6 months for IFL plus placebo (p<0.001). Median progression-free survival was 10.6 months for IFL plus bevacizumab, and 6.2 for IFL plus placebo (p<0.001); response rates were 44.8 and 34.8% (p=0.004) in favour of the patients treated with IFL plus bevacizumab. The addition of bevacizumab to FU-based combination chemotherapy results in statistically significant and clinically meaningful improvement in survival among patients with metastatic colorectal cancer .
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