Angiogenesis Inhibitors
Angiogenesis inhibitors help stop tumors from getting the blood and nutrients they need to survive by blocking the growth of new blood vessels. Because these treatments don’t attack cancer cells directly, they are different from traditional chemotherapy. Angiogenesis inhibitors are often used together with other types of cancer treatments, such as chemotherapy or immunotherapy, to help improve outcomes.
What is angiogenesis and how does it relate to cancer?
Angiogenesis is the formation of new blood vessels. This usually happens when the body sends out special chemical signals to certain cells called endothelial cells. These cells help grow new blood vessels from ones that already exist. The new blood vessels grow toward the place where the signal came from. These signals can result from things like injury or low oxygen, and angiogenesis helps bring oxygen and nutrients to tissues, which helps the body heal and stay healthy.
Cancer cells can also use this process to their advantage. Tumors need blood to grow and spread, so they send out signals stimulate angiogenesis, leading to new blood vessel formation. This allows them to get the oxygen and nutrients they need to grow and spread (metastasize).
What are angiogenesis inhibitors?
Angiogenesis inhibitors are medicines that target the formation, growth, and function of new blood vessels by cancer cells. In doing so, they prevent the cancer cells from getting the nutrients they need to grow and help the immune system work better to destroy cancer.
These drugs are given as an infusion into a vein (IV) or as pills or capsules that you swallow (oral). Some can be given alone but most are used in combination with other cancer treatments such as chemotherapy or immunotherapy. Depending on the type of cancer, they can be used as part of “first-line” treatment following diagnosis or “second-line” treatment if cancer progresses despite treatment. Angiogenesis inhibitors can also be given as maintenance therapy to help prevent or delay cancers from coming back.
How do angiogenesis inhibitors work?
Many angiogenesis inhibitors work like targeted therapy to block certain proteins such as vascular endothelial growth factor (VEGF). Blocking this protein stops the cancer cells from sending signals that trigger new blood vessel growth. This can slow or stop cancer by limiting its blood supply.
Other angiogenesis inhibitors can also make the immune system work better by helping the tumor’s blood vessels function more normally. This can:
- Help immune cells get into the tumor more easily, stick to the blood vessel walls, and attack cancer.
- Stop blood from leaking into nearby tissues, which means less swelling (edema) and better delivery of other treatments, like chemotherapy.
These medicines also help the immune system by:
- Strengthening cancer-fighting cells like T cells
- Preventing cancer cells from blocking the immune system
Which cancers are treated with angiogenesis inhibitors?
Angiogenesis inhibitors are used to treat many different types of cancer. These include some forms of solid tumors such as:
- Cervical cancer
- Colorectal cancer
- Glioblastoma
- Kidney cancer
- Liver cancer
- Multiple myeloma
- Neuroendocrine tumors
- Non-squamous cell non-small cell lung cancer
- Ovarian, fallopian tube, and peritoneal cancer
- Pancreatic cancer
- Stomach cancer
- Thyroid cancer
Types of angiogenesis inhibitors
Many different types of angiogenesis inhibitors are available. Some are classified as monoclonal antibodies, immunomodulators, and kinase inhibitors.
Examples of angiogenesis inhibitors used include:
- Axitinib (Inlyta)
- Bevacizumab (Avastin)
- Cabozantinib (Cometriq, Cabometyx)
- Everolimus (Afinitor)
- Lenalidomide (Revlimid)
- Lenvatinib (Lenvima)
- Pazopanib hydrochloride (Votrient)
- Ramucirumab (Cyramza)
- Regorafenib (Stivarga)
- Sorafebib (Nexavar)
- Sunitinib (Sutent)
- Thalidomide (Thalomid)
- Vandetanib (Caprelsa)
- Ziv-aflibercept (Zaltrap)
Side effects of angiogenesis inhibitors
Side effects of angiogenesis inhibitors vary from person to person and drug to drug based on the specific way they work. They also can range from mild to severe, and quick recognition is important. Common side effects include:
- Bleeding
- Skin changes (such as rash or dry, itchy skin)
- High blood pressure
- Hand-foot syndrome
- Fatigue
- Diarrhea
- Low blood counts
- Problems with wound healing
Less common and more serious side effects can include:
- Hemorrhage or stroke
- Heart attacks or heart failure
- Blood clots
- Holes (perforations) in the intestines
Your cancer care team will watch you closely during treatment and will check you often. Side effects can and should be treated as early as possible. It’s important to tell your cancer care team about any changes in how you feel or anything you notice that’s new or unusual. Tell them right away so they can treat any problems and try to keep them from getting worse.
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- References
Developed by the 91黑料不打烊 medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
American Society of Clinical Oncology (ASCO). Angiogenesis and angiogenesis inhibitors to treat cancer. Accessed at cancer.net. Content is no longer available.
American Society of Clinical Oncology (ASCO). What is immunotherapy? Accessed at cancer.net. Content is no longer available.
Gordon RA, Jackson N, Krause T, Mangan B, Martinez AL, Tipian CC. Immunotherapy. In Olsen MM, LeFebvre KB, Walker SL, Dunphy EP, eds. Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. 2nd ed. Pittsburgh, PA: Oncology Nursing Society; 2023:213-290.
Kuo CJ. Overview of angiogenesis inhibitors. UpToDate. 2025. Accessed at https://www.uptodate.com/contents/overview-of-angiogenesis-inhibitors on August 7, 2025.
National Cancer Institute (NCI). Angiogenesis inhibitors. Cancer.gov Updated April 2, 2018. Accessed at https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/angiogenesis-inhibitors-fact-sheet on August 7, 2025.
National Cancer Institute (NCI). Immunotherapy to treat cancer. Cancer.gov Updated September 24, 2019. Accessed at https://www.cancer.gov/about-cancer/treatment/types/immunotherapy on August 7, 2025.
Tu J. Lioang H, Li C, Huang Y, Wang, Z, Chen X, et al. The application and research progress of anti-angiogenesis therapy in tumor immunotherapy. Frontiers in Immunology. 2023; 14:1198972. doi:10.3389/fimmu.2023.1198972
Last Revised: July 7, 2025
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