Role of bevacizumab in colorectal cancer growth and its adverse effects: a review

Angiogenesis affects both wound healing and malignant cell growth through nutrients and oxygen. Vascular endothelial growth factor (VEGF) is the most important element involved in this complex process. Inhibition of VEGF influences angiogenesis and may restrict tumor growth and metastatic ability. M...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2013-08, Vol.19 (31), p.5051-5060
Main Authors: Pavlidis, Efstathios T, Pavlidis, Theodoros E
Format: Article
Language:English
Subjects:
Angiogenesis Inhibitors - adverse effects
Angiogenesis Inhibitors - therapeutic use
Animals
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Bevacizumab
Colorectal Neoplasms - blood supply
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - metabolism
Colorectal Neoplasms - pathology
Humans
Molecular Targeted Therapy
Neovascularization, Pathologic
Review
Signal Transduction - drug effects
Treatment Outcome
Tumor Burden - drug effects
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Vascular Endothelial Growth Factor A - metabolism
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Summary:Angiogenesis affects both wound healing and malignant cell growth through nutrients and oxygen. Vascular endothelial growth factor (VEGF) is the most important element involved in this complex process. Inhibition of VEGF influences angiogenesis and may restrict tumor growth and metastatic ability. Modern anti-angiogenic therapy is based on this theory. Bevacizumab is a recombinant humanized monoclonal antibody (immunoglobulin G1) which binds with VEGF-A forming a large molecule. It can not be bound with VEGF tyrosine kinase receptors preventing VEGF-A incorporation; thus its activity is inhibited inducing blockage of VEGF-mediated angiogenesis. Bevacizumab, in combination with chemotherapy or other novel targeted therapeutic agents, is currently used more frequently in clinical practice, mainly for managing advanced colorectal cancer. It is also used for managing other malignancies, such as breast cancer, pancreatic cancer, prostate cancer, non small-cell lung cancer, metastatic renal carcinoma and ovarian tumors. Although it is generally considered a safe treatment, there are reports of some rare side effects which should be taken into account. Recent experiments in rats and mice show promising results with a wider therapeutic range.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v19.i31.5051