Gail Wilkes, MS, RNC

As we review the past decade, one of the most valuable contributions to cancer care has been the success of a number of agents that block angiogenesis.

Angiogenesis is a critical requirement for malignant growth, invasion, and metastases. Agents interfering with angiogenesis have shown efficacy in the treatment of a number of solid tumors, such as metastatic colorectal cancer, non–small-cell lung cancer, and renal cell cancer, and are being studied in many more. Each of the three agents currently approved by the US Food and Drug Administration-bevacizumab (Avastin), sunitinib (Sutent), and sorafenib (Nexavar)-offer challenges to nurses, in terms of assessment and management of toxicity, and to their patients as well: learning and integrating self-care strategies, such as self-assessment and self-administration (for sorafenib and sunitinib). This article reviews the recommended dosing, drug interactions, potential side effects, and management strategies for these three agents. Other agents that have antiangiogenesis properties, such as the epidermal growth factor inhibitors, the mTOR inhibitors, bortezomib, and thalidomide will not be addressed.

bortezomib, Velcade, PR-171, PS-341, NPI-0052, Drug inhibits the action of proteasomes, which normally break down proteins that have been ubiquinated or tagged for destruction, such as p53, the "guardian of the genome," and cell cycle proteins.