Bevacizumab in the first-line therapy of advanced NSCLC

The angiogenesis inhibitor bevacizumab, a VEGF antagonist, was approved in the European Union in August 2007 for the first-line therapy of inoperable, advanced or recurrent non-small-cell lung cancer, in combination with a platin-based chemotherapy regimen. Tumors with predominantly squamous-cell histology must be excluded. Two recent phase-III studies have shown that bevacizumab, combined with carboplatin and paclitaxel (E4599) or cisplatin and gemcitabine (AVAiL), significantly prolongs overall survival and/or progression-free survival. The most common adverse events during therapy with bevacizumab are hypertension and proteinuria - both are usually well manageable. By applying correct patient selection criteria the risk of pulmonary bleeding can be greatly reduced.