MINI REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1668620
Off-label use catalogue of tumor anti-angiogenic drugs in China, a narrative review
Provisionally accepted
Difei Yao1,2*
Yangmin Hu1,2
Shanshan Weng3
Tiantian Wang1Tao Zhu1Lulu Liu1
Huan Luo1Wei He1*
Haibin Dai2,4*- 1Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- 2Research Center for Clinical Pharmacy, Zhejiang University, Hangzhou, China
- 3Department of Medical Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- 4Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Background The management of off-label use (OLU) is an important aspect of standardizing and promoting the rational use of antitumor drugs. Tumor antiangiogenic therapy (AAT) is essential in cancer therapy. However, OLU of antiangiogenic drugs is common in clinical practice. Recognizing and standardizing the OLU of AAT is a significant challenge that needs to be addressed in the clinic. Aim We aim to collect and categorize the OLU of AAT in oncology based on clinical guidelines, providing practical guidance for drug management. Method We established a multidisciplinary expert team to screen and include evidence-based OLU information. Results By organized the OLU information, it is evident that these 14 drugs of AAT have indications for 33 cancer types (36 items). Among the 14 drugs, 12 (85.7%) have OLU recommendations, totaling 215 items. These OLU recommendations were classified into four major categories. Cancer types is the most common OLU type, with 12 drugs covering 64 cancer types and 155 items. In addition, OLU in therapy lines, regimens, and dosage was involved in 3 to 4 drugs each. Bevacizumab, the most frequently involved in OLU, is associated with 12 cancer types, 3 therapy lines, 6 regimens, and 2 dosage-related OLU. In addition, lenvatinib, pazopanib, sorafenib, apatinib, and sunitinib also have OLU recommendations for more than 5 cancer types. Conclusions Our work offers an updated reference for the OLU of tumor AAT and highlights the need for further exploration into specific management measures for OLU in clinical practice.
Keywords: antiangiogenic therapy, Off-Label Use, drug label, guidelines, Drug management
Received: 18 Jul 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Yao, Hu, Weng, Wang, Zhu, Liu, Luo, He and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Difei Yao, Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Wei He, Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Haibin Dai, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.