Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer

Hari Deshpande1,3, Vicky Marler3, Julie Ann Sosa2,31Department of Medicine, 2Department of Surgery, Yale University School of Medicine, 3Yale Cancer Center, New Haven, CT, USAAbstract: Vandetanib (ZD6474) became the first systemic agent to be approved for the treatment of metastatic or locally advan...

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Main Authors: Deshpande H, Marler V, Sosa JA
Format: Article
Language:English
Published: Dove Medical Press 2011-12-01
Series:OncoTargets and Therapy
Online Access:http://www.dovepress.com/clinical-utility-of-vandetanib-in-the-treatment-of-patients-with-advan-a8830
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spelling doaj-61c1ef479f4340d68b28a6079c21f0152020-11-24T21:59:00ZengDove Medical PressOncoTargets and Therapy1178-69302011-12-012011default209215Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancerDeshpande HMarler VSosa JAHari Deshpande1,3, Vicky Marler3, Julie Ann Sosa2,31Department of Medicine, 2Department of Surgery, Yale University School of Medicine, 3Yale Cancer Center, New Haven, CT, USAAbstract: Vandetanib (ZD6474) became the first systemic agent to be approved for the treatment of metastatic or locally advanced medullary thyroid cancer. It was a proof of principle, because it is an orally bioavailable medication that targets the growth factors felt to be important in the pathogenesis of this disease, ie, the rearranged during transfection proto-oncogene and vascular endothelial growth factor receptor. It was tested initially in two Phase II studies at doses of 100 mg and 300 mg daily. Although activity was seen at both doses, the higher dose was chosen for a randomized, placebo-controlled Phase II study. This trial, which accrued more than 300 patients, showed a statistically significant benefit for the group taking vandetanib compared with those taking placebo medication. Progression-free survival for the vandetanib arm has not been reached, compared with 19 months for the placebo arm. The main toxicity appears to be diarrhea, although some patients experienced significant side effects, including torsades de pointes and sudden cardiac death. Therefore, it is now necessary for practitioners to enroll in a Risk Evaluation Mitigation Strategy before being allowed to prescribe this medication, to reduce the risk of serious side effects occurring.Keywords: ZD6474, medullary thyroid cancer, vandetanibhttp://www.dovepress.com/clinical-utility-of-vandetanib-in-the-treatment-of-patients-with-advan-a8830
collection DOAJ
language English
format Article
sources DOAJ
author Deshpande H
Marler V
Sosa JA
spellingShingle Deshpande H
Marler V
Sosa JA
Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
OncoTargets and Therapy
author_facet Deshpande H
Marler V
Sosa JA
author_sort Deshpande H
title Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
title_short Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
title_full Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
title_fullStr Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
title_full_unstemmed Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
title_sort clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer
publisher Dove Medical Press
series OncoTargets and Therapy
issn 1178-6930
publishDate 2011-12-01
description Hari Deshpande1,3, Vicky Marler3, Julie Ann Sosa2,31Department of Medicine, 2Department of Surgery, Yale University School of Medicine, 3Yale Cancer Center, New Haven, CT, USAAbstract: Vandetanib (ZD6474) became the first systemic agent to be approved for the treatment of metastatic or locally advanced medullary thyroid cancer. It was a proof of principle, because it is an orally bioavailable medication that targets the growth factors felt to be important in the pathogenesis of this disease, ie, the rearranged during transfection proto-oncogene and vascular endothelial growth factor receptor. It was tested initially in two Phase II studies at doses of 100 mg and 300 mg daily. Although activity was seen at both doses, the higher dose was chosen for a randomized, placebo-controlled Phase II study. This trial, which accrued more than 300 patients, showed a statistically significant benefit for the group taking vandetanib compared with those taking placebo medication. Progression-free survival for the vandetanib arm has not been reached, compared with 19 months for the placebo arm. The main toxicity appears to be diarrhea, although some patients experienced significant side effects, including torsades de pointes and sudden cardiac death. Therefore, it is now necessary for practitioners to enroll in a Risk Evaluation Mitigation Strategy before being allowed to prescribe this medication, to reduce the risk of serious side effects occurring.Keywords: ZD6474, medullary thyroid cancer, vandetanib
url http://www.dovepress.com/clinical-utility-of-vandetanib-in-the-treatment-of-patients-with-advan-a8830
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