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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.
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.
Selective VEGFR1-3 inhibitor with low off-target kinase activity. Connects to VEGF / VEGFR.
1.Oral dosing 3 weeks on / 1 off
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy. Two or more prior systemic therapies for RCC documented.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA512 · SMC advice: tivozanib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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| Region | Year | Indication |
|---|---|---|
| US | 2021 | Relapsed/refractory advanced RCC after ≥2 prior systemic therapies |
| EU | 2017 | EU first (Aug 2017) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Hypertension | 44% | - |
| Fatigue | 43% | - |
| Diarrhoea | 33% | - |
| Hand-foot syndrome | 15% | - |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Tivozanib" OR ABSTRACT:"Tivozanib" OR TITLE:"Fotivda" OR ABSTRACT:"Fotivda") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Tivozanib, not a curated reading list.
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