Dr. McDonald on Approved Angiogenesis Inhibitors

Donald M. McDonald, MD, PhD, a professor in the Department of Anatomy and an investigator in the Cardiovascular Research Institute at the University of California, San Francisco Comprehensive Cancer Center, discusses the three approved drugs that inhibit angiogenesis in cancer.

The first drug he mentions is bevacizumab (Avastin), which is a monoclonal antibody that inhibits vascular endothelial growth factor (VEGF). This drug is described as a large-molecule agent and is administered intravenously.

McDonald mentions there are two small-molecule drugs, oral agents, which are also available. The first of the antiangiogenesis agents is sunitinib (Sutent) which is a multi-targeted agent that blocks both VEGF and platelet-derived growth factor (PDGF) receptors. The second small-molecule drug is sorafenib (Nexavar) that also blocks the VEGF and PDGF receptors.

The two small molecule drugs have a higher rate of adverse events because they inhibit multiple pathways.