{"entity":{"id":"tivozanib","kind":"drug","name":"Tivozanib","aka":[],"tldr":"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.","status":"approved","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Tivozanib","links":[{"label":"FDA label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Tivozanib"}],"tags":[],"related":[],"cancers":["rcc"],"sections":[],"technologies":["kinase-inhibitors","antiangiogenic"],"targets":["vegf"],"drugs":[],"companies":["aveo"],"institutions":[],"pathways":[],"terms":[],"trials":["tinivo-2"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Fotivda","modality":"Small-molecule kinase inhibitor (VEGFR)","mechanism":"Selective VEGFR1-3 inhibitor with low off-target kinase activity.","approvals":[{"region":"US","year":2021,"indication":"Relapsed/refractory advanced RCC after ≥2 prior systemic therapies"},{"region":"EU","year":2017,"indication":"EU first (Aug 2017)"}],"mechanismSteps":["Oral dosing 3 weeks on / 1 off","Potent VEGFR blockade with minimal PDGFR/KIT inhibition","Less hand-foot syndrome and diarrhoea than multi-targeted TKIs"],"dosing":{"route":"Oral","schedule":"1.34 mg daily, 21 days on / 7 days off","monitoring":"Blood pressure, thyroid, liver enzymes"},"toxicity":[{"event":"Hypertension","anyGradePct":44},{"event":"Fatigue","anyGradePct":43},{"event":"Diarrhoea","anyGradePct":33},{"event":"Hand-foot syndrome","anyGradePct":15}],"access":[],"regulatoryEvents":[]},"route":"/drugs/tivozanib/","neighbours":{"cancer":[{"id":"rcc","kind":"cancer","name":"Renal cell carcinoma","route":"/cancers/rcc/"}],"technology":[{"id":"antiangiogenic","kind":"technology","name":"Anti-angiogenic therapy","route":"/technologies/antiangiogenic/"},{"id":"kinase-inhibitors","kind":"technology","name":"Small-molecule kinase inhibitors","route":"/technologies/kinase-inhibitors/"}],"target":[{"id":"vegf","kind":"target","name":"VEGF / VEGFR","route":"/targets/vegf/"}],"company":[{"id":"aveo","kind":"company","name":"AVEO Oncology (LG Chem)","route":"/companies/aveo/"}],"trial":[{"id":"nct05000294","kind":"trial","name":"Atezolizumab Plus Tivozanib in Immunologically Cold Tumor Types","route":"/trials/nct05000294/"},{"id":"nct04645160","kind":"trial","name":"Evaluating Efficacy of Tivozanib (AV-951) in Biliary Tract Cancers","route":"/trials/nct04645160/"},{"id":"tinivo-2","kind":"trial","name":"TiNivo-2","route":"/trials/tinivo-2/"}],"pairing":[{"id":"io-rechallenge-caution-rcc","kind":"pairing","name":"Caution: PD-1 rechallenge after progression on immunotherapy (RCC)","route":"/pairings/io-rechallenge-caution-rcc/"}],"pathway":[{"id":"angiogenic-switch","kind":"pathway","name":"The angiogenic switch & tumour vessels","route":"/pathways/angiogenic-switch/"}]}}