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Systemic therapy
Anti-angiogenic therapy
Medicines that attack the blood supply a tumour builds for itself.
What it is
A tumour beyond a few millimetres has to recruit its own blood vessels. Anti-angiogenic agents interfere with that signalling, starving the supply rather than attacking the cell.
They are usually given with chemotherapy rather than instead of it, and their side-effect profile is vascular: blood pressure, protein in the urine, bleeding and impaired wound healing.
When it is used
- Alongside chemotherapy in defined settings
- In maintenance, after an initial response
- Where the disease type has an established anti-angiogenic option
How the decision is made
- Blood pressure and kidney function at baseline, and a plan for monitoring both.
- Any planned surgery, these agents impair wound healing and must be stopped well before an operation and restarted well after it.
- Bleeding risk, particularly with tumours close to a major vessel or airway.
Infusion at a partner day-care unit, or oral at home depending on the agent.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Candidacy and combination decision at the board
- Baseline blood pressure, urine protein and renal assessment
- A written monitoring schedule
- Surgical timing coordination, stop and restart windows
- Cost and access mapping
Performed and billed elsewhere
- The infusion
- The medicine
- Imaging for response assessment
- Tell any surgeon or dentist that you are on an anti-angiogenic agent before any procedure, including a tooth extraction. Wound healing is affected for weeks after the last dose.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- What is this adding to the chemotherapy?
- What happens to my blood pressure, and who monitors it?
- If I need surgery, how long must I stop before and after?
- What are the bleeding risks in my case?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Colorectal cancer
Colon and rectal cancer, bowel cancer
Lung & thoracic cancer
Non-small cell and small cell lung cancer, mesothelioma, thymic tumours
Kidney cancer
Renal cell carcinoma
Ovarian cancer
Epithelial ovarian, fallopian tube and primary peritoneal cancer
Liver cancer
Hepatocellular carcinoma, HCC
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.