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MARKERS OF RESPONSE FOR BEVACIZUMAB 

J Clin Oncol. 2013 Feb 11. [Epub ahead of print]
Markers of Response for the Antiangiogenic Agent Bevacizumab.Lambrechts D, Lenz HJ, de Haas S, Carmeliet P, Scherer SJ.
Source
Abstract

Diether Lambrechts and Peter Carmeliet, Vesalius Research Center, Flanders Institute for Biotechnology (VIB), and University of Leuven, Leuven, Belgium; Heinz-Josef Lenz, Keck School of Medicine, University of Southern California, Los Angeles; Stefan J. Scherer, Genentech, South San Francisco, CA; and Sanne de Haas, F. Hoffmann-La Roche, Basel, Switzerland.

Bevacizumab is the first antiangiogenic therapy proven to slow metastatic disease progression in patients with cancer. Although it has changed clinical practice, some patients do not respond or gradually develop resistance, resulting in rather modest gains in terms of overall survival. A major challenge is to develop robust biomarkers that can guide selection of patients for whom bevacizumab therapy is most beneficial. Here, we discuss recent progress in finding such markers, including the first results from randomized phase III clinical trials evaluating the efficacy of bevacizumab in combination with comprehensive biomarker analyses. In particular, these studies suggest that circulating levels of short vascular endothelial growth factor A (VEGF-A) isoforms, expression of neuropilin-1 and VEGF receptor 1 in tumors or plasma, and genetic variants in VEGFA or its receptors are strong biomarker candidates. The current challenge is to expand this first set of markers and to validate it and implement it into clinical practice. A first prospective biomarker study known as MERiDiAN, which will treat patients stratified for circulating levels of short VEGF-A isoforms with bevacizumab and paclitaxel, is planned and will hopefully provide us with new directions on how to treat patients more efficiently.