Martín M, et al. - Data from two similar phase III randomized trials of endocrine therapy (ET) ± bevacizumab (Bev) (LEA and Cancer and Leukemia Group B 40503) was evaluated (a post-hoc analysis) by experts in order to compare the addition of bevacizumab ET vs experimental ET + Bev as first-line treatment for hormone receptor-positive metastatic breast cancer. Women at least 18 years old, postmenopausal, with a diagnosis of unresectable, locally advanced or metastatic breast cancer, hormone receptor-positive and human epidermal growth factor receptor 2 negative were eligible for the study. A total of 749 subjects were recruited and categorized to ET or ET + Bev groups. Median progression-free survival (PFS) for ET and for ET + Bev was 14.3 months and 19 months, respectively. The objective response rate and clinical benefit rate with ET and ET + Bev were estimated to be 40 vs 61% and 64 vs 77%, respectively. No variation in overall survival (OS) was observed. For endocrine-sensitive subjects, PFS was higher for ET + Bev. For ET + Bev, grade III-IV hypertension, proteinuria, cardiovascular and liver events were markedly higher. Hypertension and proteinuria were not noted as predictors of efficiency. Therefore, the addition of Bev to ET elevated PFS overall and in endocrine-sensitive subjects but not OS at the expense of notable additional toxicity.