{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:24:19Z","timestamp":1783578259732,"version":"3.55.0"},"reference-count":109,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy \u201cCarol Davila\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Overall, it is estimated that more than 3,500,000 patients have received Bevacizumab as part of systemic oncologic treatment. Bevacizumab and its biosimilars are currently marketed in over 130 countries. Given the wide usage of Bevacizumab in current oncological practice, it is very important to compare the \u201creal-world\u201d results to those obtained in controlled clinical trials. This study aims to describe the clinical experience of using Bevacizumab in a large cohort of cancer patients in \u201cnon-controlled real-world\u201d conditions with regard to effectiveness, safety, and cost of therapy. Methods: For this purpose, we conducted an open, observational, retrospective study involving all patients treated for solid malignant tumors in the Bucharest Institute of Oncology with \u201cProf. Dr. Al. Trestioreanu\u201d with Bevacizumab-based systemic therapy, between 2017 and 2021. Results: The study consisted of 657 treatment episodes in 625 patients (F\/B = 1.62\/1, with a median age of 57.6 years) which were treated for malignant tumors (majority colorectal, non-small cell lung, ovarian, and breast cancer). First-line treatment was administered in 229 patients, and the rest received Bevacizumab as second or subsequent lines of treatment. The overall response rate to Bevacizumab-based therapies was around 60\u201365% across all indication except for subsequent treatment lines in colorectal and ovarian cancers, where lower values were recorded (27.1%, and 31.5% respectively). Median PFS for the entire cohort was 8.2 months (95% CI 6.8\u20139.6), and the median OS was 13.2 months (95% CI 11.5\u201314.9). Usual bevacizumab-related toxicities were observed, including bleeding, hypertension, wound-healing complications, gastrointestinal perforation, other types of fistulas, septic complications, and thromboembolic events. Although the clinical benefits are undeniable, the addition of Bevacizumab to standard chemotherapy increased the overall treatment cost by 213%. Conclusions: Bevacizumab remains a high-cost therapy, but it can add to clinical benefits (like overall survival, progression-free survival, and response rate) when used in conjunction with standard chemotherapy. Similar results as those presented in various controlled trials are observable even on unselected cohorts of patients in the uncontrolled conditions of \u201creal-world\u201d oncological practice. Off-label usage is encountered in clinical practice, and this aspect should be monitored given the potential adverse effects of the therapy.<\/jats:p>","DOI":"10.3390\/cancers16142590","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T15:15:19Z","timestamp":1721402119000},"page":"2590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Bevacizumab-Based Therapies in Malignant Tumors\u2014Real-World Data on Effectiveness, Safety, and Cost"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9225-8030","authenticated-orcid":false,"given":"Elena","family":"Chitoran","sequence":"first","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6161-1951","authenticated-orcid":false,"given":"Vlad","family":"Rotaru","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0839-0651","authenticated-orcid":false,"given":"Sinziana-Octavia","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisa","family":"Gelal","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina-Mirela","family":"Capsa","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Radiology Department, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana-Elena","family":"Bohiltea","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Obstetrics and Gynecology Department, \u201cFilantropia\u201d Clinical Hospital, 011132 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina-Nicoleta","family":"Mitroiu","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Obstetrics and Gynecology Department, \u201cFilantropia\u201d Clinical Hospital, 011132 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-2112","authenticated-orcid":false,"given":"Dragos","family":"Serban","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Surgery Department 4, Bucharest University Emergency Hospital, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-4269","authenticated-orcid":false,"given":"Giuseppe","family":"Gullo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela-Cristina","family":"Stefan","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurentiu","family":"Simion","sequence":"additional","affiliation":[{"name":"Medicine School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1126\/science.284.5415.808","article-title":"Effects of Angiogenesis Inhibitors on Multistage Carcinogenesis in Mice","volume":"284","author":"Bergers","year":"1999","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1056\/NEJM197111182852108","article-title":"Tumor Angiogenesis: Therapeutic Implications","volume":"285","author":"Folkman","year":"1971","journal-title":"N. Engl. J. 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