Abstract
Fluoropyrimidine-based regimens have become the standard adjuvant treatment for stage III colorectal cancer (CRC). Despite the superior outcomes with adjuvant 5-FU/leucovorin/oxaliplatin schedules, nearly one third of node-positive CRC patients still recur. Bevacizumab is a recombinant humanized monoclonal antibody to vascular endothelial growth factor, which has demonstrated efficacy in terms of progression-free survival, and overall survival for patients with metastatic CRC. These positive results formed the basis to explore its role in the adjuvant setting. To answer the question of whether bevacizumab would add on overall and/or disease-free survival, two large randomized phase 3 trials (NSABP C-08 and AVANT) tested the addition of bevacizumab to standard oxaliplatin-based adjuvant chemotherapy in early-stage CRC patients. However, the addition of anti-angiogenic therapy to adjuvant scenario failed to improve disease-free survival and overall survival. This article aimed to explain the reasons why bevacizumab had no impact on the outcomes of adjuvant treatment of colorectal cancer.
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