Editorial
Future of Bevacizumab in Metastatic Breast Cancer
Habib Nourani Khojasteh*
Department of Internal Medicine, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz-Iran
*Corresponding author: Habib Nourani Khojasteh, Department of Internal Medicine, Hematology Research Center, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz-Iran
Published: 21 Apr, 2017
Cite this article as: Khojasteh HN. Future of Bevacizumab
in Metastatic Breast Cancer. Ann Clin
Case Rep. 2017; 2: 1341.
Editorial
Bevacizumab is an interesting antitumor drugs in clinical cancer medicine, its effect on survival
of patients confirmed in metastatic colon cancer, renal cancer, lung cancer, ovarian cancer and
glioblastoma but despite using with many combination chemotherapy in metastatic breast cancer
with capcitabine, taxanes, gemcitabine, doxorubicin no effects on overall survival and progression
free survival seen [1,2]. It is a humanized monoclonal antibody against vascular endothelial growth
factor A and impairs its binding to vascular endothelial growth factor receptor type1 and type2 and
leads to tumor shrinkages. the basic mechanisms is that, antiangiogenesis treatment normalizes
tumor flow initially resulting important tissue oxygenation and decreased interstitial pressure with
increasing the delivery of cytotoxic agents to tumor. They confer better efficacy in combination
with chemotherapy during earlier treatment because late stage breast cancer expresses many
different angiogenic factors such as fibroblast growth factors in contrast early cancer express more
vascular endothelial growth factors. If in future the biomarker would be a clinical practice, especially
circulating tumor cells, it is possible to select and predict the activity of the disease and targeted
therapy with bevacizumab to be done on precise time of tumors with angiogenesis activity [3,4].
Probably, considering the breast cancer carcinogenesis starting with a very small size tumor activity,
it is possible to control the tumor more efficiently by antiangiogenesis drugs, may be attempting for
curability of breast cancer in next decades.
Because of its antiangiogenesis effects on central nervous system metastasis, in future it can be a
preventive drug therapy delaying seeding of tumor in life threating site of body which is difficult to
control by oncologist. How can we accelerate the effectiveness of bevacizumab in metastatic breast
cancer? It needs to have knowledge and control the reactivation of other mechanisms of tumor
growth in breast cancer biology. Activation of epidermal growth factor pathway; Here 2 pathway,
endocrine redundant and cycloxygenase 2 pathways are the common mechanisms of failure [5-8].
Conclusion
Regarding the failure of survival effects of bevacizumab in metastatic breast cancer this is not the end of the drug in this disease entity, bevacizumab therapy in future still has a maior role in metastatic breast cancer.
References
- Adhemar Longatto Filho, Jose Manuel Lopes, Fernando C Schmitt. Angiogenesis and Breast Cancer. J Oncol. 2010;2010.
- Marino N, Woditschka S, Reed LT, Nakayama J, Mayer M, Wetzel M, et al. Breast cancer metastasis: issues for the personalization of its prevention and treatment. Am J Pathol. 2013;183(4):1084-95.
- Steeg PS. Tumor metastasis: mechanistic insights and clinical challenges. Nat Med. 2006;12(8):895-904.
- Bryan P Sneider, Kathy D Miller. Angiogenesis of breast cancer. J Clin Oncol. 2005;23:8.
- Nourani Khojasteh H. Lessons about antiangiogenesis treatment of breast cancer in the current era. Med Res Archives. 2017;5(2).
- Lord S, Harris AL. Angiogenesis - still a worthwhile target for breast cancer therapy? Breast Cancer Res. 2010;12(4):S19.
- Fox SB, Generali DG, Harris AL. Breast tumour angiogenesis. Breast Cancer Res. 2007;9(6):216.
- Castañeda-Gill JM, Vishwanatha JK. Antiangiogenic mechanisms and factors in breast cancer treatment. J Carcinog. 2016;15:1.