Bevacizumab in combination with taxanes for the first-line treatment of metastatic breast cancer.

BACKGROUND Taxanes are an established treatment of metastatic breast cancer (mBC). Biological therapies that can be effectively combined with taxanes may provide an alternative to taxane-chemotherapy doublets, which are not suitable for all patients. PATIENTS AND METHODS Bevacizumab is a humanised mAb against vascular endothelial growth factor (VEGF) which inhibits angiogenesis. This review summarises outcomes from trials evaluating bevacizumab in the first-line treatment of mBC. RESULTS Bevacizumab demonstrated considerable efficacy in combination with taxane therapy in the first-line treatment of human epidermal growth factor receptor-2 (HER2)-negative mBC in three phase III trials. Improved response rate and progression-free survival (PFS) were also observed in patients who had received taxanes in the adjuvant setting. Bevacizumab-taxane combinations are effective across a broad range of patient subgroups and have greater efficacy than single-agent taxanes in first-line mBC. Importantly, the tolerability of bevacizumab-taxane combinations compares favourably with that of taxanes in combination with other chemotherapy agents. CONCLUSIONS Bevacizumab-taxane combinations provide an alternative to chemotherapy doublet regimens in first-line mBC, with equivalent efficacy and potentially lower toxicity. Ongoing trials are investigating the efficacy and safety of bevacizumab in various stages of breast cancer and in breast cancer with a range of hormonal or receptor characteristics.