Cancer Genetics and Epigenetics, 2025, Vol.13, No.3, 126-135 http://medscipublisher.com/index.php/cge 128 Table 1 Overallpatient exposure to bevacizumab in clinical trial and post-marketing setting (Adopted from Coleman et al., 2020) Indication Patient exposure in manufacturer-sponsored clinical trials Estimated patient exposure in post-marketing setting Gastrointestinal cancer/CRC 12319 2024 159 Breast cancer 10242 325154 Lung cancer/NSCLC 8316 630173 Renal cancer 1305 43247 Glioblastoma multiforme 1083 97728 Female reproductive tract cancer and cervical cancer/OC, FTC, PPC+CC 1907 326062 Other cancer 2024 29237 Total 37196 350059 Table caption: Abbreviations CC: Cervical cancer; CRC: Colorectal cancer; FTC: Fallopian tube cancer; NSCLC: Non-small cell lung cancer; oC: Ovarian cancer, PC; Prima peritoneal cancer (Adopted from Coleman et al., 2020) 3.2 Summary of clinical trial data Many large-scale trials and actual observational studies have found that bevacizumab combination therapy can improve the key therapeutic indicators of patients. The average time for patients' conditions not to deteriorate is approximately 10.7 to 12.1 months, and the average survival time can be prolonged to 22.7 to 31.4 months. The specific figures are related to the treatment plan and the patients' conditions (Mazier et al., 2009; Cazzaniga et al., 2015; Couture et al., 2023). The proportion of patients with shrinking tumors is also good. Different studies show that this proportion ranges from 38.6% to 65% (Tonini et al., 2014; Tsuji et al., 2016; Luo et al., 2025). For instance, the BEAT study demonstrated that when bevacizumab was combined with chemotherapy, the average time for patients' conditions not to deteriorate was 10.8 months, and the average survival time was 22.7 months (Mazier et al., 2009). The TRIBE study found that the average survival time of patients treated with FOLFOXIRI combined with bevacizumab was 29.8 months, which was more effective than FOLFIRI combined with bevacizumab (25.8 months). The proportion of patients with tumor shrinkage was 65% instead of 53% (Tonini et al., 2014; Cazzaniga et al., 2015). These results all indicate that when treating advanced colorectal cancer, first-line chemotherapy combined with bevacizumab is indeed effective. 3.3 Factors affecting therapeutic effect Genetic changes in the patient's body, such as mutations in the RAS and BRAF genes, can have a significant impact on the therapeutic effect of bevacizumab. Compared with patients with gene mutations, patients with normal RAS and BRAF genes have a longer overall survival time. For instance, patients with normal genes survived for an average of 37.1 months, those with RAS gene mutations survived for an average of 25.6 months, and those with BRAF gene mutations survived for an average of 13.4 months (Zhou et al., 2024). However, bevacizumab is effective regardless of the patient's genetic condition, so this drug has a relatively wide range of applications (Cazzaniga et al., 2015; Luo et al., 2025). There are other factors, such as the size of the tumor and the patient's physical condition, which can also affect the treatment outcome. If the tumor is too large or the patient's physical condition is too poor, the treatment effect may not be good. However, if appropriate maintenance treatment and conversion treatment methods are adopted, especially for patients with RAS gene mutations, the time for the disease not to deteriorate can be prolonged and the quality of life can be improved (Luo et al., 2025). These findings indicate that it is very important to formulate personalized treatment plans based on patients' genes and physical conditions. 4 Value in Later-Line Treatments 4.1 Effectiveness in second- and third-line therapy settings Bevacizumab combined with other drugs for the treatment of metastatic colorectal cancer is still very useful during the second and third treatments. Studies have found that compared with other similar anti-cancer drugs, bevacizumab treatment can enable patients to live longer, have their conditions not deteriorate for a longer period
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