Why would you choose to add bevacizumab to a chemotherapy regimen?
The data are pretty compelling. You significantly add to the efficacy of standard chemotherapies by adding bevacizumab to chemotherapy. Moreover, the tolerability of adding bevacizumab is really exceptional. It adds very little in the way of toxicity, so in quality of life you lose nothing. Patients I think tolerate the antibody so well, and given its benefit, I would routinely add bevacizumab to first-line chemotherapy.
There are a few rare circumstances where you might not add bevacizumab, namely if there's a risk of perforation or if the patient has a fistula from the surgery, you wouldn't want to give bevacizumab within 4 weeks of surgery. So if you're starting chemotherapy shortly after surgery, you might delay adding bevacizumab until 4 weeks have transpired.
Unresectable Colon Cancer: Case 1
68-year-old man was diagnosed with advanced, unresectable colon cancer has just started treatment with FOLFIRI plus bevacizumab.