Cancer Genetics and Epigenetics, 2025, Vol.13, No.3, 126-135 http://medscipublisher.com/index.php/cge 126 Meta Analysis Open Access Efficacy and Adverse Effects of Bevacizumab Combination Therapy in Advanced Colorectal Cancer Wei Zhang Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China Corresponding email: weizhang@qq.com Cancer Genetics and Epigenetics, 2025, Vol.13, No.3 doi: 10.5376/cge.2025.13.0013 Received: 04 Apr., 2025 Accepted: 10 May, 2025 Published: 30 May, 2025 Copyright © 2025 Zhang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Zhang W., 2025, Efficacy and adverse effects of bevacizumab combination therapy in advanced colorectal cancer, Cancer Genetics and Epigenetics, 13(3): 126-135 (doi: 10.5376/cge.2025.13.0013) Abstract This study analyzed the efficacy and safety of bevacizumab combined with chemotherapy in the treatment of advanced colorectal cancer (CRC). Bevacizumab is an important drug that inhibits vascular growth. It can act on VEGF-A and prevent tumors from growing new blood vessels. Both clinical trials in hospitals and observations during actual treatment have found that when bevacizumab is used in combination with commonly used chemotherapy regimens (such as FOLFOX and FOLFIRI), the proportion of tumor shrinkage and the proportion of disease control in patients will both increase. This study also explored the conditions of the patients after treatment, which are related to their own genetic changes (such as RAS and BRAF genes), tumor size, and physical conditions, etc. In the subsequent treatment, bevacizumab has a very good effect on patients with normal RAS/BRAF genes and is more effective than other similar targeted drugs (such as afericept and ramucirumab). This treatment method works well, but there are no particularly reliable indicators yet to know in advance whether the treatment is effective or not and whether it will cause side effects. Future research should focus on identifying these indicators, attempting new combined treatment methods (such as being used in combination with immunotherapy), and adopting more precise treatment approaches. In this way, the treatment effect for patients with advanced colorectal cancer will be better and their quality of life will be higher. Keywords Bevacizumab; Advanced colorectal cancer; Anti-angiogenic therapy; Progression-free survival (PFS); Personalized treatment 1 Introduction Advanced colorectal cancer (CRC) has always been a major global health challenge. Many people suffer from this disease and the risk of death is also very high. Many patients are diagnosed with cancer when it has already metastasized. Although there are now some treatments for the whole body, the therapeutic effects are not very satisfactory, and the patients' lifespan is still not long (Liu et al., 2018; Wang et al., 2021; Couture et al., 2023). Bevacizumab is a drug specifically targeting vascular endothelial growth factor (VEGF). When treating advanced colorectal cancer, it is particularly important to use it to inhibit the growth of tumor blood vessels. When used in combination with common chemotherapy regimens (such as FOLFOX, XELOX or FOLFIRI), whether at the beginning of treatment or after re-treatment when the previous treatment was ineffective, it can prolong the period during which the patient's condition does not deteriorate. Some patients can even live longer (Wang et al., 2021; Cremolini et al., 2023; Couture et al., 2023). Compared with chemotherapy alone, when combined with bevacizumab, more patients have their tumors shrink and more have their conditions controlled. This indicates that it is very useful in the treatment of advanced cancer (Liu et al., 2018; Wang et al., 2021; Wang et al., 2022; Cremolini et al., 2023). This study will systematically assess the efficacy and safety of bevacizumab combination therapy in advanced colorectal cancer. By synthesizing evidence from randomized controlled trials and meta-analyses. This study aims to clarify the benefits and risks associated with bevacizumab-based regimens, inform clinical decision-making, and highlight areas for future research. 2 Pharmacological Basis of Bevacizumab 2.1 Mechanism of action: inhibition of vascular endothelial growth factor A Bevacizumab is a special artificial drug that can specifically bind to vascular endothelial growth factor A
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