Bevacizumab: direct anti-VEGF therapy in renal cell carcinoma

Bevacizumab, in combination with IFN, is approved in the EU as first-line therapy for advanced and/or metastatic renal cell carcinoma (mRCC). Data from Avastin and Roferon in Renal Cell Carcinoma [BO17705] (AVOREN), a Phase III trial, demonstrated that bevacizumab plus IFN significantly improves progression-free survival and response rate in patients with previously untreated mRCC compared with IFN plus placebo. Furthermore, bevacizumab plus IFN is well tolerated and has a predictable and well-established tolerability profile; reducing the dose of IFN, when necessary, can effectively manage IFN-related side effects without compromising efficacy. The rapid evolution of options for RCC therapy means that the optimal use of available agents to maximize patient benefit is not currently well defined. Combination regimens and sequencing of agents are both being investigated to maximize future outcomes, with bevacizumab playing a key role in first-line regimens. Trials over the next 5 years will guide clinical practice, but bevacizumab plus IFN is currently a standard first-line option for mRCC.