Bevacizumab demonstrated preclinical and clinical activity in colorectal cancer and Genentech chose this as the disease for their registration studies. At ASCO 2003 Hurwitz et al reported the results of their phase III study of standard bolus irinotecan/5-FU/LV (IFL) plus bevacizumab (5 mg/kg). An impressive median survival advantage (20.3 months vs. 15.6 months [p=0.00003]) was reported in 925 patients receiving first line therapy with irinotecan, 5-fluorouracil, leucovorin treatment for metastatic colorectal cancer. Only grade 3 hypertension (11%), easily managed with oral medications, was clearly increased in this Phase III study. Gastrointestinal perforation, although rare, was possibly seen more frequently.