Bevacizumab for the first-line treatment of human epidermal growth factor receptor 2-negative advanced breast cancer

Purpose of review Breast cancer is the most common cancer in women worldwide and its incidence is increasing as a result of the continued adoption of lifestyles associated with increased risk factors. Approximately, 75% of breast cancers do not express the human epidermal growth factor receptor 2 (HER2), including hormone receptor-positive and triplenegative tumors. HER2-negative breast cancers are resistant to, or eventually become resistant to, existing targeted treatments such as HER2-targeted agents and hormone therapies, and, as a consequence, are associated with poorer outcomes than HER2-positive breast cancer. Bevacizumab is a humanized monoclonal antibody that recognizes vascular endothelial growth factor-A, a rate-limiting step in pathological angiogenesis such as tumor growth. As angiogenic pathways become more complex as breast cancer progresses, angiogenesis inhibitors should be initiated earlier in the disease course. This review will discuss the evidence for bevacizumab as first-line therapy in metastatic breast cancer, with a particular focus on patients with HER2-negative disease. Recent findings Bevacizumab, when administered in combination with first-line standard chemotherapy, significantly increases progression-free survival and overall response rate in patients with metastatic breast cancer. Summary Novel targeted therapies that are appropriate to HER2-negative breast cancer, such as bevacizumab, may represent valuable therapeutic options in the clinical management of metastatic breast cancer.