Cancer Genetics and Epigenetics, 2025, Vol.13, No.3, 126-135 http://medscipublisher.com/index.php/cge 127 (VEGF-A), rendering this factor ineffective. VEGF-A is the key element for the growth of new blood vessels in tumors. Bevacizumab can prevent the growth of new blood vessels in tumors by inhibiting VEGF-A, and these new blood vessels are necessary for tumor growth and metastasis. In this way, it can inhibit the growth of tumor cells and kill cancer cells (Zondor and Medina, 2004; Motl, 2005; Coleman et al., 2020; Kaneko et al., 2022). Preventing VEGF-A from functioning can not only prevent new blood vessels from growing in the tumor, but also change the environment around the tumor. This may reduce the suppression of the human immune system by tumors and make other anti-cancer treatments more effective. It is precisely because of this effect of preventing tumors from growing blood vessels that bevacizumab is particularly important in combination treatment regimens for advanced colorectal cancer and other cancers (Zondor and Medina, 2004; Coleman et al., 2020; Kaneko et al., 2022). 2.2 Pharmacokinetic characteristics and clinical administration methods The effect of bevacizumab in the human body is related to the dosage of the drug. Administered by intravenous injection once (0.1~10mg /kg), the maximum concentration of the drug in the blood can reach 2.8 to 284 μg/mL. The responses of different patients to this drug vary. Moreover, in patients with metastatic colorectal cancer, the connection between the dosage and the therapeutic effect can also be observed (Motl, 2005; Romera et al., 2018; Muller et al., 2025). When treated in the hospital, bevacizumab is administered to patients through intravenous infusion, typically once every two weeks, with 5 mg/kg of body weight each time. It is usually used in combination with fluorouracil chemotherapy regimens such as FOLFOX or FOLFIRI. If the patient has poor renal or liver function, there is no need to adjust the dosage of the medication. Such a medication arrangement is to achieve the best therapeutic effect and reduce side effects at the same time (Motl, 2005; Romera et al., 2018; Muller et al., 2025). 2.3 Indications for the treatment of colorectal cancer Bevacizumab was initially approved for use in combination with chemotherapy to treat metastatic colorectal cancer, which was a major breakthrough in targeted therapy for this disease. Later, the types of cancers it could treat increased, but it was still a commonly used drug in the treatment of advanced colorectal cancer (Motl, 2005; Coleman et al., 2020; Kaneko et al., 2022). In actual treatment, bevacizumab combined with commonly used chemotherapy regimens can increase the tumor shrinkage rate of patients with metastatic colorectal cancer, prolong the time when the disease does not deteriorate, and also increase the total survival time. Because of its good therapeutic effect and controllable side effects, it has become an important drug for treating such patients (Table 1) (Zondor and Medina, 2004; Motl, 2005; Zhou et al., 2015; Coleman et al., 2020; Kaneko et al., 2022). 3 The Therapeutic Effect of the First-Line Combined Treatment 3.1 Synergistic effect with chemotherapy regimens such as FOLFOX and FOLFIRI When bevacizumab is used in combination with common chemotherapy regimens such as FOLFOX (oxaliplatin, fluorouracil, calcium folinate) and FOLFIRI (irinotecan, fluorouracil, calcium folinate), they can cooperate with each other, making the treatment of metastatic colorectal cancer more effective. After adding bevacizumab, it can enhance the effect of chemotherapy drugs by preventing the growth of new blood vessels in the tumor. As a result, the tumor receives less nutrients and the chemotherapy drugs kill cancer cells more effectively (Mazier et al., 2009; Tonini et al., 2014; Couture et al., 2023). Clinical research has found that when FOLFOX and FOLFIRI are combined with bevacizumab respectively, the therapeutic effects are similar. Doctors can flexibly choose the treatment plan based on the patient's physical condition and adverse reactions after medication. Compared with chemotherapy alone, the combined use of the two drugs can keep the patient's condition from deteriorating for a longer time and cause more patients with tumor shrinkage. Therefore, this has become a common method for treating metastatic colorectal cancer (Mazier et al., 2009; Tonini et al., 2014; Tsuji et al., 2016; Couture et al., 2023).
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