Other targeted therapies block the growth of blood vessels to tumors (angiogenesis). To grow beyond a certain size, tumors must obtain a blood supply to get the oxygen and nutrients needed for continued growth. Treatments that interfere with angiogenesis may block tumor growth.
- Bevacizumab (Avastin®) is a monoclonal antibody that is approved for the treatment of glioblastoma. It is also approved for some patients with non-small cell lung cancer, metastatic colorectal cancer, and metastatic kidney cancer. Bevacizumab binds to the vascular endothelial growth factor (VEGF). This prevents VEGF from interacting with its receptors on endothelial cells, a step that is necessary for the initiation of new blood vessel growth.
- Sorafenib (Nexavar®) is a small-molecule inhibitor of tyrosine kinases that is approved for the treatment of advanced renal cell carcinoma and some cases of hepatocellular carcinoma. One of the kinases that sorafenib inhibits is involved in the signaling pathway that is initiated when VEGF binds to its receptors. As a result, new blood vessel development is halted. Sorafenib also blocks an enzyme that is involved in cell growth and division.
- Sunitinib (Sutent®) is another small-molecule tyrosine kinase inhibitor that is approved for the treatment of patients with metastatic renal cell carcinoma or gastrointestinal stromal tumor that is not responding to imatinib. It blocks kinases involved in VEGF signaling, thereby inhibiting angiogenesis and cell proliferation.
- Pazopanib (Votrient®) is approved for the treatment of patients with advanced renal cell carcinoma. Pazopanib is a small-molecule inhibitor of several tyrosine kinases, including VEGF receptors, c-kit, and platelet-derived growth factor receptor.