# Tivozanib

Source: https://onco.cc/drugs/tivozanib/  
OnCo record `tivozanib` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Tivozanib is a VEGF-receptor pill that hits VEGFR1 to 3 with little off-target kinase activity, so it is better tolerated than other anti-angiogenic pills, though hypertension and fatigue remain common. It is approved for kidney cancer after two or more prior treatments, and its TiNivo-2 trial showed that restarting immunotherapy after failure adds nothing.

## Summary

Tivozanib is a VEGFR1-3 inhibitor with low off-target kinase activity, which explains its relatively favourable tolerability among anti-angiogenic pills. In TIVO-3 (2019) it gave PFS 5.6 versus 3.9 months against sorafenib in third line and beyond, leading to FDA approval in March 2021 for advanced RCC after at least 2 prior systemic therapies. TiNivo-2 (2024 to 2026) then tested adding nivolumab after prior immunotherapy: PFS was 5.7 versus 7.4 months (HR 1.10), so rechallenge gave no benefit, and with CONTACT-03 this settled the IO-rechallenge question in RCC for now. Hypertension (44%) and fatigue (43%) are the main adverse effects. AVEO developed it and was acquired by LG Chem in 2023. It is a well-tolerated later-line VEGFR pill whose own trial showed that restarting immunotherapy after failure does not help.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Fotivda
- Modality: Small-molecule kinase inhibitor (VEGFR)
- Mechanism: Selective VEGFR1-3 inhibitor with low off-target kinase activity.
- Approvals: US 2021: Relapsed/refractory advanced RCC after ≥2 prior systemic therapies; EU 2017: EU first (Aug 2017)
- Dosing: Oral; 1.34 mg daily, 21 days on / 7 days off

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Tivozanib
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Tivozanib

## Connected records

- cancers: [Renal cell carcinoma](https://onco.cc/cancers/rcc/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/), [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- targets: [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- companies: [AVEO Oncology (LG Chem)](https://onco.cc/companies/aveo/)
- trials: [Atezolizumab Plus Tivozanib in Immunologically Cold Tumor Types](https://onco.cc/trials/nct05000294/), [Evaluating Efficacy of Tivozanib (AV-951) in Biliary Tract Cancers](https://onco.cc/trials/nct04645160/), [TiNivo-2](https://onco.cc/trials/tinivo-2/)
- pairings: [Caution: PD-1 rechallenge after progression on immunotherapy (RCC)](https://onco.cc/pairings/io-rechallenge-caution-rcc/)
- pathways: [The angiogenic switch & tumour vessels](https://onco.cc/pathways/angiogenic-switch/)

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