Angiogenesis Inhibitors

What are angiogenesis inhibitors?

Angiogenesis inhibitors are medications that prevent blood vessels that supply cancerous tumors from forming. They’re also called anti-angiogenics, anti-angiogenic agents and anti-angiogenic therapy.

Tumors need a steady supply of nutrient-rich blood to grow and spread. When they’re small, tumors can absorb blood from nearby healthy tissue. But by the time a tumor reaches 1 to 2 millimeters, it needs to sprout blood vessels to “feed” and grow.

Angiogenesis inhibitors interfere with the process that tumors use to make blood vessels. They slow tumor growth and, in some cases, shrink tumors. Although this treatment can’t get rid of cancer for good, it can slow tumor growth and allow you more time with your loved ones.

How do angiogenesis inhibitors work?

These drugs block a process called angiogenesis. Usually, angiogenesis is part of your body’s normal healing process. In response to an injury, damaged cells release a signal, like an SOS. The signal triggers the formation of new capillaries out of existing blood vessels. The capillaries supply blood to the area, helping it heal.

But tumors can also use angiogenesis to grow capillaries. These new blood vessels nourish the tumor, helping it grow and spread.

Angiogenesis inhibitors disrupt the signaling process that drives angiogenesis. Most work by blocking a protein called vascular endothelial growth factor (VEGF). Think of VEGF as the primary SOS signal that damaged cells (and tumors) release. When VEGF binds to VEGF receptors, it spurs the formation of blood vessels.

Depending on the specific drug, angiogenesis inhibitors disrupt signals by:

• Preventing VEGF from binding to receptors. Some drugs bind to VEGF so it can’t attach to the VEGF receptors on cancer cells. Bevacizumab (Avastin^®), a type of monoclonal antibody, is an example.
• Preventing VEGF receptors from sending signals. Drugs called tyrosine kinase inhibitors block VEGF receptors from sending signals. Examples include sorafenib (Nexavar^®) and sunitinib (Sutent^®).
• Blocking other signaling processes. Some drugs block other signals involved in tumor angiogenesis. Examples include immunomodulators, like thalidomide (Synovir, Thalomid^®) and lenalidomide (Revlimid^®).

What conditions are treated with angiogenesis inhibitors?

Healthcare providers most often prescribe angiogenesis inhibitors to treat advanced or recurrent cancers. Types include some forms of:

• Brain cancer
• Breast cancer
• Cervical cancer
• Colon cancer
• Fallopian tube cancer
• Kidney cancer
• Liver cancer
• Lung cancer
• Lymphoma
• Multiple myeloma
• Pancreatic cancer
• Peritoneal cancer
• Stomach cancer
• Thyroid cancer
• Uterine (endometrial) cancer

Providers also prescribe anti-angiogenics to treat eye diseases that involve abnormal blood vessel growth. These drugs are also known as VEGF inhibitors. They specifically block vascular endothelial growth factor (VEGF).

What happens during treatment?

Healthcare providers usually prescribe angiogenesis inhibitors alongside other cancer treatments, like immunotherapy and chemotherapy. The anti-angiogenics starve tumors of their blood supply. The other treatments kill the actual cancer cells.

Depending on the drug type, you may need to take a pill once or twice a day. Or you may get regular infusions through an IV.

How long will I need anti-angiogenic therapy?

Your treatment schedule will depend on the type of drug you need. Most people take anti-angiogenics until they stop working. Some people stop once the side effects become unmanageable.

Your healthcare provider will help you weigh the benefits of treatment against potential side effects.

What are the potential benefits of this treatment?

Angiogenesis inhibitors starve tumors of the nutrients they need to grow and spread. They can slow cancer progression so you can live longer.

How successful are angiogenesis inhibitors?

Medical experts continue to research ways to make angiogenesis inhibitors more effective. Over time, cancers often build up resistance to the drugs. This treatment can also cause unpleasant side effects.

Still, angiogenesis inhibitors may be one part of an effective treatment plan to keep cancer at bay.

What are the risks or complications of this treatment?

Many potential health risks involve issues with bleeding and blood clots. In rare cases, side effects of angiogenesis inhibitors can be life-threatening. They include:

• High blood pressure
• Internal bleeding
• Slow wound healing
• Gastrointestinal perforation
• An underactive thyroid gland
• Toxic hepatitis or liver damage
• Serious blood clots (some could lead to heart problems or a stroke)

Your healthcare provider will monitor your health to reduce your risk of complications.

How can I take care of myself?

The most important thing you can do is understand potential side effects and risks before you start taking an angiogenesis inhibitor. Knowing what to expect can help you become more aware of your body so you know when to contact your healthcare provider. Your provider can advise you on how to manage side effects. Or they can change your dosage or medication.

Are there natural angiogenesis inhibitors?

Certain foods contain compounds that block some of the signals involved in angiogenesis. Many of these foods are a part of the Mediterranean diet. These natural angiogenesis inhibitors include:

• Asparagus
• Dandelion root
• Green tea
• Olive oil
• Peanuts
• Red wine
• Red grapes
• Safflower

Medical experts are studying ways to use these compounds to create new anti-angiogenic drugs. But this research is still in the early stages.

It’s important to remember that these foods aren’t a substitute for cancer drug therapies. (In other words, eating more red grapes or peanuts won’t stop tumors from growing.)

Still, eating nutrient-rich foods is an important part of nourishing your body. And nourishing your body is essential when it comes to cancer treatment and prevention.

When should I call my healthcare provider?

Contact your healthcare provider if you’re experiencing unexpected symptoms during treatment. Seek emergency care if you notice signs of a life-threatening complication, like a stroke or heart attack.