Although a direct inhibitory action of Lenvatinib on Ang-2 is uncertain, anti-VEGF is thought to reduce Ang-2 expression in tumor cells by normalizing tumor vessels and making the tumor microenvironment less hypoxic, explaining the decreases in serum Ang-2 levels by Lenvatinib treatment described in several reports [23,25]. This evidence concerns the gene VEGFA and neoplasm.