Cancer Genetics and Epigenetics, 2025, Vol.13, No.3, 126-135 http://medscipublisher.com/index.php/cge 131 overall survival time was 27.9 months, which is basically consistent with the data from clinical trials (Lungulescu et al., 2023; Matsumoto et al., 2024). These results indicate that the therapeutic effects observed in the comparative trials can also be achieved in daily medical treatment. Figure 1 Survival curves of patients with mCCR treated with bevacizumab (Adopted from Lungulescu et al. 2023) 6.2 Differences in efficacy and toxicity among different populations Actual treatment studies in different regions have shown that the efficacy and side effects of bevacizumab treatment are largely similar among different populations, but there are also differences. In the studies in South Korea and Japan, the lifespan of patients and the probability of side effects were similar to those in Western studies. However, some side effects, such as neutropenia in white blood cells, might be more common in Asian patients (Kim et al., 2020; Matsumoto et al., 2024). A practical analysis in South Korea found that adding bevacizumab at the beginning of chemotherapy is beneficial for patients who cannot undergo local treatments such as surgery and can prolong their survival time. This effect is similar to the results of Western studies (Kim et al., 2020). However, differences in the patient's initial physical condition, the convenience of subsequent treatment methods, and genetic characteristics can all affect the treatment outcome. Therefore, when analyzing the treatment results of different populations, all these factors must be taken into account (Lungulescu et al., 2023; Matsumoto et al., 2024). 6.3 Compliance and management challenges in clinical practice When actually seeking medical treatment, whether a patient can be treated with bevacizumab as planned is influenced by side effects, other diseases, and some practical difficulties. Real treatment studies have found that many patients stop treatment prematurely due to side effects or deteriorating health. In some studies, only 45% of the patients were able to complete the initial treatment course as planned (Matsumoto et al., 2024). To deal with side effects such as hypertension, proteinuria and neutropenia, it is necessary to frequently observe the patient's condition and adjust the dosage of medication in a timely manner. This is more difficult to achieve in the daily medical treatment in hospitals than in experiments. Moreover, for elderly patients and those with multiple diseases at the same time, specialized treatment plans should be formulated based on their conditions, and more follow-up examinations should be conducted. Only in this way can the treatment effect be guaranteed and the risks be reduced (Deplanque et al., 2020; Lungulescu et al., 2023; Matsumoto et al., 2024). 7 Current Challenges and Research Prospects 7.1 Lack of biomarkers for predicting efficacy and toxicity When using bevacizumab to treat colorectal cancer, a major challenge currently faced is that there are no reliable indicators to know in advance which patients will respond to the drug and which patients may experience side effects. Although scientists have conducted extensive research on many factors related to vascular growth and other molecular indicators, no indicator has been found so far that can accurately predict how long colorectal cancer patients treated with bevacizumab can live or whether they will develop drug resistance (Yeung and Tebbutt, 2012; Coleman et al., 2020; Wang et al., 2025). However, recent research has discovered something that might be useful, such as MAGEA3. In those tumors that are resistant to bevacizumab, the content of MAGEA3 becomes very high, and the time during which the patient's
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