Drug updated on 4/10/2024
| Dosage Form | Tablet (oral; 100 mg, 300 mg) |
| Drug Class | Kinase inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For the treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.
Summary
- Vandetanib (Caprelsa) has shown significant effectiveness in prolonging progression-free survival and overall survival in patients with various types of thyroid cancer, including medullary and differentiated thyroid cancers. It induced an objective response in 33.8% of patients with medullary thyroid cancer, offering a moderate therapeutic benefit.
- Eight systematic reviews/meta-analyses were reviewed to compare Caprelsa (vandetanib) with other Tyrosine Kinase Inhibitors and Multikinase Inhibitors for the treatment of advanced forms of thyroid cancer.
- When directly compared with drugs like cabozantinib and sorafenib, vandetanib offers favorable progression-free survival times but has a different toxicity profile. Lenvatinib showed the best efficacy but also had the highest incidence of adverse events.
- Adverse events specifically associated with vandetanib include QTc prolongation which requires monitoring during treatment. Like other TKIs, it has been linked to significant adverse events leading to dose interruption or reduction, with its specific risk factors including an increase in proteinuria events.
- Both cabozantinib and vandetanib improve progression-free survival compared to placebo, according to the reviewed studies' findings, but they did not demonstrate significant benefits in terms of overall survival. Their high incremental cost-effectiveness ratios suggest careful consideration of their cost against their benefits within EU-label population groups.
- Certain analyses indicated that risks such as developing high-grade adverse effects like proteinuria were more pronounced in patients suffering from hepatocellular carcinoma or renal cell carcinoma than in those diagnosed with thyroid cancer. This suggests varying safety profiles among different patient subgroups, necessitating tailored therapy approaches based on individual needs and disease characteristics.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Caprelsa (vandetanib) Prescribing Information. | 2022 | Sanofi Genzyme Cambridge, MA |