How Do Antineoplastic VEGF Inhibitors Work?

Antineoplastic vascular endothelial growth factor (VEGF) inhibitors are a class of drugs used to treat various types of cancers including the kidney, colon rectum, lung, liver, breast cancer, and glioblastoma (a type of cancerous brain tumor).

VEGF inhibitors are cancer-fighting agents that work by inhibiting angiogenesis through the inhibition of the VEGF pathway. Angiogenesis is a process of formation of new blood vessels which involves migration, growth, and differentiation of endothelial cells, which lines the inside wall of blood vessels.

The process of angiogenesis is controlled by chemical signals in the body. Some of these signals, such as VEGF, bind to receptors on the surface of normal endothelial cells that signal the initiation of the growth and survival of new blood vessels.

Tumors can release chemical signals that can stimulate angiogenesis, a critical step for the growth and development of tumors. The resulting new blood vessels feed the growing tumors with oxygen and nutrients, allowing the tumor to enlarge and the cancer cells to invade nearby tissue, to move throughout the body and form new colonies of cancer cells called metastases.

VEGF inhibitors are administered via intravenous (into a vein) and oral routes.

VEGF inhibitors work in the following ways:

• They belong to a class of medications called “tyrosine kinase inhibitors” that work by decreasing the blood supply to the tumors. 
• They also belong to a class of medications called “antiangiogenic agents” that work by preventing the formation of blood vessels that supply oxygen and nutrients to tumors. This may slow the growth and spread of tumors.

Antineoplastic VEGF inhibitors are used to treat conditions such as:

• Metastatic colorectal cancer
• Non-small cell lung cancer
• Gastric cancer
• Differentiated thyroid cancer
• Endometrial cancer (a type of cancer that begins in the uterus)
• Soft tissue sarcomas
• Renal cell carcinoma (kidney cancer)
• Cervical cancer (cancer that begins in the opening of the uterus) 
• Ovarian, fallopian tube, or peritoneal cancer
• Glioblastoma (an aggressive type of cancer that can occur in the brain or the spinal cord)
• Breast cancer
• Hepatocellular carcinoma (liver cancer)
• A gastrointestinal stromal tumor (soft tissue sarcomas that can be located in any part of the digestive system)
• Pancreatic neuroendocrine tumors

Some of the common side effects include:

• Nausea
• Vomiting
• Constipation
• Diarrhea
• Dry mouth
• Loss of appetite
• Dysgeusia (a taste disorder that causes foul, rancid, metallic, or salty taste perception)
• Abdominal pain
• Headache
• Tiredness/weakness
• Mouth sores
• Joint/muscle pain
• Dryness of skin

Other rare side effects include:

• Dizziness 
• Fatigue 
• Hair loss
• Weight loss
• Chest pain
• Anemia (low red blood cell count)
• Insomnia 
• Shortness of breath
• Chills, sore throat, fever, or cough
• Thrombocytopenia (low blood platelet count)
• Hypocalcemia (low blood calcium level)
• Hypertension (high blood pressure)
• Hyperglycemia (high blood glucose level)
• Confusion
• Swelling of the face, eyes, stomach, hands, feet, ankles, or lower legs
• Epistaxis (bleeding from the nose)
• Peripheral edema (swelling of lower legs or hands)
• Stomatitis (an inflamed and sore mouth)
• Dysphonia (disorders of the voice)
• Hypokalemia (low blood potassium level)
• Increased creatinine 

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of antineoplastic VEGF inhibitors include:

• Avastin
• Axitinib
• Bevacizumab
• Bevacizumab-awwb
• Bevacizumab-bvzr
• Cyramza
• Fotivda
• Inlyta
• Lenvatinib
• Lenvima
• Mvasi
• Nexavar
• Pazopanib
• Ramucirumab
• Retevmo
• Selpercatinib
• Sorafenib
• Sunitinib
• Surufatinib (pending Food and Drug Administration approval)
• Sutent
• Tivozanib
• Votrient
• Zirabev