Should bevacizumab be continued beyond progression in colorectal cancer?

Medical therapy for advanced colorectal cancer has seen signifi cant changes over the past decade. Most recently, molecular targeted agents such as antibodies against the epidermal growth factor receptor and the vascular endothelial growth factor (VEGF) have become integral components of treatment algorithms for this disease. The anti-VEGF antibody bevacizumab has been found to sig-nifi cantly prolong progression-free and overall survival when used (in conjunction with chemotherapy) as part of fi rst-line or second-line treatment. Recent preclinical and clinical data suggest that continuing bevacizumab beyond fi rst progression could be associated with a relevant clinical benefi t for patients with advanced colorectal cancer, but there are no data from randomized clinical trials on this issue. This review discusses the current state of the science and the rationale for and against continuing bevacizumab as part of antitumor therapy beyond progression of colorectal cancer.