Tivozanib

Tivozanib is an oral, small-molecule tyrosine kinase inhibitor that selectively targets vascular endothelial growth factor receptors 1, 2 and 3, reducing tumor blood vessel formation and slowing the growth of certain cancers. It is marketed under the brand Fotivda in some regions and was developed by AVEO Oncology. The drug is typically given as an oral dose once daily for five days in a 28-day cycle (for example, 1 mg daily on days 1–5 of each cycle).

Clinical use and indications include advanced renal cell carcinoma (RCC) in adults after prior systemic therapy. Regulatory status has varied by region: it was approved in the European Union for RCC after failure of one prior systemic therapy, and in the United States it was approved in 2021 for adults with relapsed or refractory RCC following the failure of at least two prior systemic therapies. Its approval status may differ in other markets and depends on regional regulatory assessments.

Safety and adverse effects are an important consideration. Common adverse events include hypertension, fatigue, diarrhea, decreased appetite, thrombocytopenia, and proteinuria. Serious risks include arterial and venous thromboembolism, hemorrhage, wound healing impairment, and electrolyte abnormalities. Monitoring typically involves regular blood pressure checks, kidney function tests, and urine protein assessment, with dose adjustments for toxicity as indicated.

Pharmacology and overview: tivozanib embodies a VEGF receptor–directed therapy with a profile aimed at anti-angiogenic activity. Its use is principally in RCC after prior therapy, with regional approvals guiding exact indications and regimens.