Drug updated on 11/1/2024
| Dosage Form | Tablet (oral; 100 mg, 300 mg) |
| Drug Class | Kinase inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indiacted for the treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.
Latest News
Summary
- This summary is based on the review of seven systematic review(s)/meta-analysis(es). [1-7]
- Vandetanib and other MKIs, including Cabozantinib, Lenvatinib, and Sorafenib, were associated with changes in glucose and lipid metabolism, with elevated glucose levels observed in 1-17% of cases, hypercholesterolemia in 4-40%, and hypertriglyceridemia in 1-86%.
- Among 13 treatments for radioiodine-refractory differentiated thyroid cancer (RAIR-DTC), Vandetanib showed less favorable progression-free survival (PFS) compared to Lenvatinib, which had a hazard ratio of 0.31 (0.20-0.49). Vandetanib ranked lower in overall survival (OS) than Apatinib.
- In medullary thyroid carcinoma (MTC), Vandetanib induced an objective response in 33.8% of patients, with disease progression occurring in 23.7%.
- Vandetanib was associated with a high incidence of grade 3 or higher adverse events in certain populations, including a 48.5% rate in medullary thyroid carcinoma (MTC) patients, with 44.7% of patients discontinuing treatment due to adverse events.
- Common adverse effects of Vandetanib included metabolic disorders (e.g., hypercholesterolemia, hypertriglyceridemia) and QTc prolongation, with gastrointestinal side effects and other manageable adverse events frequently observed across thyroid cancer types.
- Studies focused on adult cancer patients across different types of advanced cancers, including RAIR-DTC, HCC, and MTC, with subgroup analyses comparing treatment responses and survival outcomes specific to differentiated thyroid cancer (DTC), refractory thyroid cancer, and advanced medullary thyroid carcinoma (MTC).
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Caprelsa (vandetanib) Prescribing Information. | 2024 | Sanofi Genzyme Cambridge, MA |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Guidelines on the Use of Systemic Therapy in Patients with Advanced Thyroid Cancer | 2023 | Clinical Oncology |
| ESMO Clinical Practice Guideline update on the use of systemic therapy in advanced thyroid cancer | 2022 | Annals of Oncology |
| Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. | 2022 | Journal of NCCN |
| Current Guidelines for Management of Medullary Thyroid Carcinoma. | 2021 | Endocrinology and Metabolism |
| The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer. | 2020 | Endocrine Journal |
| SEOM clinical guideline thyroid cancer (2019). | 2020 | Annals of Oncology |