Angiogenesis and Angiogenesis Inhibitors to Treat Cancer

Approved by the Cancer.Net Editorial Board, 05/2022

Angiogenesis inhibitors are a type of cancer treatment. They stop a process in the body called angiogenesis, or blood vessel formation.

What is angiogenesis? How do angiogenesis inhibitors treat cancer?

Angiogenesis is how the body forms new blood vessels. This is a normal part of growth and healing. But sometimes angiogenesis can play a role in diseases such as cancer.

To grow, a tumor needs nutrients and oxygen from your blood. The tumor sends signals that stimulate more blood vessels to grow and carry more blood.

Angiogenesis inhibitors, also called anti-angiogenics, block blood vessel growth. By blocking nutrients and oxygen from a tumor, the angiogenesis inhibitors "starve" the tumor.

What angiogenesis inhibitors are approved to treat cancer?

The U.S. Food and Drug Administration has approved several angiogenesis inhibitors. They may affect angiogenesis in more than one way, and some of them can also affect other ways that a tumor grows. Angiogenesis inhibitors can be given alone or in combination with other types of treatment.

Examples of angiogenesis inhibitors that are approved to treat cancer are:

Axitinib (Inlyta) is approved to treat:

  • Kidney cancer

Bevacizumab (Avastin) is approved to treat:

  • Cervical cancer

  • Colorectal cancer

  • Glioblastoma

  • Kidney cancer

  • Liver cancer

  • Non-squamous non-small cell lung cancer (NSCLC)

  • Ovarian, fallopian tube, and peritoneal cancers

Cabozantinib (Cometriq, Cabometyx) is approved to treat:

  • Kidney cancer

  • Liver cancer

  • Differentiated thyroid cancer

  • Medullary thyroid cancer

Everolimus (Afinitor) is approved to treat:

  • Breast cancer

  • Gastrointestinal neuroendocrine tumors

  • Kidney cancer

  • Neuroendocrine lung cancer

  • Pancreatic neuroendocrine tumors (PNET)

  • Subependymal giant cell astrocytoma, a rare type of noncancerous brain tumor

Lenalidomide (Revlimid) is approved to treat:

  • Anemia caused by myelodysplastic syndromes (MDS)

  • Follicular lymphoma

  • Mantle cell lymphoma

  • Marginal zone lymphoma

  • Multiple myeloma

Lenvatinib (Lenvima) is approved to treat:

  • Endometrial carcinoma

  • Kidney cancer

  • Liver cancer

  • Thyroid cancer

Pazopanib hydrochloride (Votrient) is approved to treat:

  • Kidney cancer

  • Soft tissue sarcoma

Ramucirumab (Cyramza) is approved to treat:

  • Colorectal cancer

  • Liver cancer


  • Stomach adenocarcinoma

  • Gastroesophageal junction adenocarcinoma, a cancer located where the stomach joins the esophagus

Regorafenib (Stivarga) is approved to treat:

  • Colorectal cancer

  • Gastrointestinal stromal tumor (GIST)

  • Liver cancer

Sorafenib (Nexavar) is approved to treat:

  • Kidney cancer

  • Liver cancer

  • Thyroid cancer

Sunitinib (Sutent) is approved to treat:

  • Gastrointestinal stromal tumor (GIST)

  • Kidney cancer

  • Pancreatic neuroendocrine tumors (PNET)

Thalidomide (Synovir, Thalomid) is approved to treat:

  • Multiple myeloma.

Thalidomide is not recommended during pregnancy because it causes severe birth defects.

Vandetanib (Caprelsa) is approved to treat:

  • Medullary thyroid cancer

Ziv-aflibercept (Zaltrap) is approved to treat:

  • Colorectal cancer

Researchers are studying whether some of these drugs may treat other types of cancer. Talk with your health care team about clinical trials for angiogenesis inhibitors.

What are the side effects of angiogenesis inhibitors?

Many of the body's normal functions depend on angiogenesis. Therefore, angiogenesis inhibitors can cause a wide range of physical side effects including:

  • High blood pressure

  • A rash or dry, itchy skin

  • Hand-foot syndrome, which causes tender, thickened areas on your palms and soles. Sometimes, it causes blisters.

  • Diarrhea

  • Fatigue

  • Low blood counts

  • Problems with wound healing or cuts reopening

Although common, these side effects do not happen with every drug or every person. And, there are medicines can help manage these side effects when they do occur. Be sure to let your health care team know about side effects you experience.

Rare side effects include:

  • Serious bleeding

  • Heart attacks

  • Heart failure

  • Blood clots

  • Holes in the intestines, called bowel perforations

If an angiogenesis inhibitor is recommended for you, talk with your doctor about the specific potential benefits and risks of that medication. Also, ask about ways side effects can be managed and what side effects to watch for.

How are angiogenesis inhibitors given?

Angiogenesis inhibitors for cancer can be prescribed by a doctor to take orally (by mouth) or intravenously (by vein; IV).

If you are prescribed an oral angiogenesis inhibitor to take at home, ask if you need to fill the prescription at a pharmacy that handles complex medications, such as a specialty pharmacy. Check with the pharmacy and your insurance company about your insurance coverage and co-pay of the oral medication. Also, be sure to ask about how to safely store and handle your prescription at home.

If you are prescribed an IV treatment, that will be given at the hospital or other cancer treatment facility. Talk with your treatment center and insurance company about how your specific prescription is covered and how any co-pays will be billed.

If you need financial assistance, talk with your health care team, including the pharmacist or a social worker, about co-pay assistance options.

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 possible risks and benefits of the drug?

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

  • How long will this treatment last?

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

  • Will I take this drug at home or at the hospital?

  • Will I need other cancer treatments in addition to this angiogenesis inhibitor?

  • Which clinical trials are options for me?

  • Who can help me manage the costs of my prescriptions?

Related Resources

Understanding Targeted Therapy

Skin Reactions to Targeted Therapy and Immunotherapy

More Information

National Cancer Institute: Angiogenesis Inhibitors

The Angiogenesis Foundation: Treatments