No standard therapeutic strategy for metastatic breast cancer (MBC) currently exists; however, the availability of effective targeted therapies provides a strong rationale for evaluating novel combinations of these agents to develop multipronged approaches that inhibit specific and different pathways in cancer development. The efficacy and tolerability of bevacizumab-based therapy in combination with a range of cytotoxic agents as first-line treatment for MBC have now been demonstrated in several studies. The statistically significant and clinically relevant benefit in progression-free survival observed with the addition of bevacizumab to chemotherapy as first-line treatment of MBC, combined with its favorable safety profile, indicates that bevacizumab is able to potentiate the activity of conventional chemotherapy without exacerbating its toxicity. Bevacizumab currently is being investigated in combination with numerous agents, including chemotherapy doublets. Ongoing trials will help define the optimal approach for integration of antivascular endothelial growth factor agents, such as bevacizumab, into effective treatment strategies.
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