Vascular endothelial growth factor inhibiting drug specific toxicities

Vascular endothelial growth factor inhibiting drugs (VEGF-i) either inhibit the VEGF ligand, its receptor or components of the downstream pathways. Such drugs are growing in numbers but are frequently used either alone, or in combination with SACT in oncology. Commonly used drugs include: aflibercept, axitinib, bevacizumab, cabozantinib, cediranib, lenvatinib, pazopanib, regorafenib, sorafenib, sunitinib, tivozanib and vandetanib.  

These all have their own unique toxicities but some adverse events common to most drugs in this group will be discussed further and include:  

  1. Hypertension  
  2. Proteinuria 
  3. Bleeding  
  4. Arterial and venous thromboembolism
  5. Delay in wound healing or wound complications 
  6. Gastrointestinal perforation  
  7. Reversible posterior leukoencephalopathy syndrome 
  8. Aneurysm development and artery dissection.  

The information in this section and sub-sections is from: Edinburgh Cancer Centre. Guidelines for managing VEGF-inhibitor - related side effects. S\Tox\26. v1.1.