Episode 375: Pharmacology 101: VEGF Inhibitors

“We’re really using these in many, many types of malignancies. But you can see this class of drug, these monoclonal antibodies, the small molecule inhibitors, being used in colorectal cancer, ovarian cancer, renal cell carcinoma, brain cancers, hepatocellular, non-small cell lung cancer, gynecologic malignancies, so lots of different types of cancers where we’re seeing these drugs used,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about the vascular endothelial growth factor (VEGF) inhibitor drug class.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 8, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learner will report an increase in knowledge related to the use of VEGF inhibitors in the treatment of cancer.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Pharmacology 101 series
• Episode 303: Cancer Symptom Management Basics: Ocular Toxicities
• Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications
• Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis
• Episode 161: Administer Bevacizumab Infusions With Confidence
• ONS Voice articles:
• Manage Afatinib’s Adverse Events to Keep Patients on Treatment
• Oncology Drug Reference Sheet: Cabozantinib
• Oncology Drug Reference Sheet: Fruquintinib
• Patient Education Needs With Pazopanib Therapy for Soft Tissue Sarcoma
• ONS books:
• Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
• Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses: Safe Handling Basics
• Clinical Journal of Oncology Nursing article: Safety and Adverse Event Management of VEGFR-TKIs in Patients With Metastatic Renal Cell Carcinoma
• Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation
• ONS Oral Anticancer Medication Learning Library
• ONS Oral Anticancer Medication Toolkit
• IV Cancer Treatment Education Sheets
• Oral Chemotherapy Education Sheets

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Highlights From This Episode

“Cancer cells are known to secrete factors that cause the formation of new blood vessels, and tumors need blood vessels to supply themselves with nutrients so that they can grow and metastasize. A lot of tumors overexpress these factors, so they had more of this ability to create new blood vessels. You may hear that term somewhere neo vascularization. … And also these factors can increase the permeability of blood vessels, so making them kind of leaky blood vessels. … So the thought behind it is being able to block the ability for this new blood vessel formation and to decrease that leakiness or permeability of those blood vessels.” TS 2:07

“These are drugs that are tyrosine kinase inhibitors. These are oral, small molecule drugs that are acting intracellular, so they are working within the cell to bind and prevent that downstream signaling of producing more blood vessels. So we have a number of small molecule drugs that fall into this class. Many of them target multiple types of receptors, VEGF being included, but also a lot of these drugs have other targets.” TS 7:58

“I would really say, number one, something that we very commonly see with this drug class is hypertension. Giving you an example of bevacizumab—If we look at any grade hypertension, this can be up to 67% of patients, so very common toxicity really spanning all of these agents. So something that we need to be monitoring closely for.” TS 13:24

“With that impaired wound healing, keeping that in mind, as we are planning for this agent, for patients and even sometimes with the minor surgical procedures, maybe a need for a short hold, and even for something like a catheter placement. I know and some of the providers I work with have a preference for holding for a short period of time around that as well.” TS 20:15

“I think one big area, and we’ve seen some of this just recently, and particularly in the hepatocellular setting, we’re seeing combinations of using the VEGF inhibitor class with immunotherapy. And so I think we’re going to continue to see that evolve. Even hearing about some bispecific antibodies that are in development, where they are targeting VEGF as well as PD-L1, so getting the immunotherapy and VEGF effects.” TS 24:44