Angiogenesis and Angiogenesis Inhibitors to Treat Cancer

Aprobado por la Junta Editorial de Cancer.Net, 07/2017

Angiogenesis is the formation of new blood vessels. This process is a normal part of growth and healing. It is also plays a role in several diseases, including cancer.

A tumor needs nutrients and oxygen to grow and spread. These are available in the blood.

The tumor sends chemical signals that stimulate blood vessel growth. And the blood vessels carry blood to the tumor.

Angiogenesis inhibitors are drugs that block angiogenesis. These drugs are also called anti-angiogenics. Blocking nutrients and oxygen from a tumor can “starve” it.

These drugs are an important part of treatment for some cancer types.

Cancer treatments that block angiogenesis

Certain drugs affect angiogenesis in one or more ways. Many also affect other ways that tumors grow. These drugs are often given with other types of treatment. Talk with your health care team to learn more about these and other angiogenesis inhibitors.

The following are examples of angiogenesis inhibitors:

Axitinib (Inlyta). This is an option for kidney cancer.

Bevacizumab (Avastin). This is used for colorectal, kidney, and lung cancers.

Cabozantinib (Cometriq). This is used for medullary thyroid cancer and kidney cancer.

Everolimus (Afinitor, Zortress). This is used for kidney cancer, advanced breast cancer, and pancreatic neuroendocrine tumors (PNETs). The drug is also an option for subependymal giant cell astrocytoma, a rare type of noncancerous brain tumor.

Lenalidomide (Revlimid). This is used for multiple myeloma and tumors involving cells that normally produce antibodies. It’s also used for mantle cell lymphoma. That is a type of non-Hodgkin lymphoma.

Pazopanib (Votrient). This is used for kidney cancer and advanced soft tissue sarcoma.

Ramucirumab (Cyramza). This is used for advanced stomach cancer and gastroesophageal junction adenocarcinoma, a cancer located where the stomach joins the esophagus. The drug is also used for colorectal and non-small cell lung cancers.

Regorafenib (Stivarga). This is used for colorectal cancer and gastrointestinal stromal tumors (GIST).

Sorafenib (Nexavar). This is an option for kidney, liver, and thyroid cancers.

Sunitinib (Sutent). This is used to treat kidney cancer, PNETs, and GIST.

Thalidomide (Synovir, Thalomid). This is a treatment for multiple myeloma. Women who are pregnant should not take this drug. It’s harmful to fetuses.

Vandetanib (Caprelsa). This is another option for medullary thyroid cancer.

Ziv-aflibercept (Zaltrap). This is an option for colorectal cancer.

Researchers are studying many of these drugs for types of cancer not listed here. Talk with your health care team for more information about anti-angiogenic clinical trials.

Side effects of angiogenesis inhibitors

Angiogenesis is important to many of the body’s normal processes. Therefore, these drugs can cause a wide range of side effects:

  • High blood pressure

  • A rash or dry, itchy skin

  • Hand-foot syndrome. This causes tender, thickened areas on the palms and soles. It sometimes causes blisters.

  • Diarrhea

  • Fatigue

  • Low blood counts

  • Problems with wound healing or cuts re-opening

Some of these side effects may be common. However, they don’t happen with every drug or every person. Additionally, medicines can help manage these side effects.

Rare side effects:

  • Serious bleeding

  • Heart attacks

  • Heart failure

  • Blood clots

  • Holes in the intestines, called bowel perforations

If you have a high risk for these conditions, talk with your health care team. Ask about the risks and benefits of angiogenesis inhibitors. Also ask about ways to watch for these risks.

Questions to ask your health care team

Consider asking these questions about angiogenesis inhibitors:

  • Do you recommend an angiogenesis inhibitor as part of my treatment plan? Which one? Why?

  • What are the risks and benefits of the drug?

  • What are the potential short- and long-term side effects?

  • How long will this treatment last?

  • How is this drug different from chemotherapy or other treatments?

  • Will this drug be used in addition to other treatments?

  • What clinical trials are open to me?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • Should I be asking any other questions?

More Information

Understanding Targeted Therapy

Skin Reactions to Targeted Therapies

Side Effects

Additional Resources

National Cancer Institute: Angiogenesis Inhibitors

The Angiogenesis Foundation: Treatments