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Bevacizumab + endocrine therapy is a combination regimen used primarily in the treatment of hormone receptor–positive metastatic breast cancer. Bevacizumab is a recombinant, humanized monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), inhibiting tumor angiogenesis. Endocrine therapy typically involves agents that modulate estrogen receptor (ER) or block estrogen production/action, such as aromatase inhibitors or selective estrogen receptor degraders/modulators. The rationale for this combination arises from evidence that neoangiogenesis, driven by VEGF, contributes to resistance against endocrine therapy in breast cancer. Combination trials (such as LEA and CALGB 40503) indicate that adding bevacizumab to endocrine therapy increases progression-free survival and overall/objective response rates compared to endocrine therapy alone, particularly in endocrine-sensitive populations; however, no significant benefit in overall survival has been demonstrated, and toxicity (notably hypertension and proteinuria) increases[1][3].
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