Angiogenesis and Angiogenesis Inhibitors to Treat Cancer

Approved by the Cancer.Net Editorial Board, 11/2018

The formation of new blood vessels is called angiogenesis. It is a normal part of growth and healing. But it plays a role in several diseases, including cancer.

A tumor needs nutrients and oxygen to grow and spread. Blood contains those ingredients. The tumor sends chemical signals that stimulate blood vessel growth. And the blood vessels carry blood to the tumor.

Angiogenesis inhibitors, also called anti-angiogenics, are drugs that block angiogenesis. Blocking nutrients and oxygen from a tumor “starves” it. These drugs are an important part of treatment for some types of cancer.

Cancer treatments that block angiogenesis

Certain drugs affect angiogenesis in one or more ways. Many angiogenesis inhibitors also affect other ways that tumors grow. People may receive these drugs with other types of treatment.

Examples of angiogenesis inhibitors are:

Axitinib (Inlyta). A treatment option for kidney cancer.

Bevacizumab (Avastin). A treatment option for colorectal, kidney, and lung cancers.

Cabozantinib (Cometriq). A treatment option for medullary thyroid cancer and kidney cancer.

Everolimus (Afinitor, Zortress). A treatment option for kidney cancer, advanced breast cancer, pancreatic neuroendocrine tumors (PNETs), and subependymal giant cell astrocytoma, which is a rare type of noncancerous brain tumor.

Lenalidomide (Revlimid). A treatment option for multiple myeloma, tumors involving cells that normally produce antibodies, and mantle cell lymphoma, which is a type of non-Hodgkin lymphoma.

Pazopanib (Votrient). A treatment option for kidney cancer and advanced soft tissue sarcoma.

Ramucirumab (Cyramza). A treatment option for advanced stomach cancer; gastroesophageal junction adenocarcinoma, a cancer located where the stomach joins the esophagus; colorectal cancers; and non-small cell lung cancers.

Regorafenib (Stivarga). A treatment option for colorectal cancer and gastrointestinal stromal tumors (GIST).

Sorafenib (Nexavar). A treatment option for kidney, liver, and thyroid cancers.

Sunitinib (Sutent). A treatment option for kidney cancer, PNETs, and GIST.

Thalidomide (Synovir, Thalomid). A treatment option for multiple myeloma. Women who are pregnant should not take this drug. It harms fetuses.

Vandetanib (Caprelsa). A treatment option for medullary thyroid cancer.

Ziv-aflibercept (Zaltrap). A treatment option for colorectal cancer.

Researchers are studying whether some of these drugs may treat other types of cancer. Talk with your health care team about anti-angiogenic clinical trials.

Side effects of angiogenesis inhibitors

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

  • High blood pressure

  • A rash or dry, itchy skin

  • Hand-foot syndrome. This causes tender, thickened areas on the 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 medicines can help manage these side effects.

Rare side effects are:

  • Serious bleeding

  • Heart attacks

  • Heart failure

  • Blood clots

  • Holes in the intestines, called bowel perforations

Talk with your health care team about the risks and benefits of angiogenesis inhibitors. And ask about ways to prevent serious side effects.

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 I receive this drug along with other treatments?

  • Which clinical trials are options for me?

  • Who can help me manage the costs of cancer care?

Related Resources

Understanding Targeted Therapy

Skin Reactions to Targeted Therapy and Immunotherapy

More Information

National Cancer Institute: Angiogenesis Inhibitors

The Angiogenesis Foundation: Treatments