Vandetanib almost doubles progression free survival in patients with thyroid cancer

Results of a phase 2 randomised trial for patients with advanced differentiated thyroid cancer (DTC) show that those treated with the oral targeted agent vandetanib survived without the disease getting worse for almost twice as long as patients given placebo (11.1 months vs 5.9 months). The findings, published Online First in The Lancet Oncology, are the first to show clear evidence of prolonged progression free survival (PFS) with a targeted agent for advanced DTC, a disease for which no effective treatment exists.

Over the past decade, the incidence of has more than doubled worldwide. Recently, multi-targeted have emerged as promising treatments for DTC, but until now, no placebo-controlled studies have been done.

Here, Martin Schlumberger from the Institut Gustave Roussy in France and colleagues aimed to establish whether vandetanib, a drug that targets three proteins known to play a key role in the growth and spread of thyroid cancer—endothelial growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), and RET (REarranged during Transfection) protooncogene—would impact PFS and overall survival (OS).

The study randomly assigned 145 late-stage or advanced DTC patients from seven European countries to either 300 mg/day of vandetanib (72 patients) or placebo (73).

Compared with placebo, vandetanib was associated with significantly improved PFS of 11.1 months compared with 5.9 months. At 6 months, patients treated with vandetanib also had a significantly better disease control rate (DCR; which includes complete and partial responses and stable disease) than those given placebo. However, no significant difference in OS was noted between the groups.

Interestingly, patients with the more common papillary cancer (PTC) experienced more prolonged PFS (median PFS 16.2 months) than patients with either FTC or differentiated carcinoma (median PFS 7.7 months).

Patients who received vandetanib experienced much greater toxicities, in particular increased QTc prolongation (the lengthening of a specific interval of time in the heart's electrical cycle that can lead to death), diarrhoea, asthenia (weakness), and fatigue. Two treatment-related deaths also occurred in the vandetanib group.

According to Schlumberger, "These results are potentially good news for patients with aggressive DTC who currently have few treatment options. The significant improvements in PFS and DCR versus suggest that vandetanib may be an effective treatment option for long-term stabilization of advanced DTC, particularly for patients with PTC."

In a linked Comment, Keith Bible from the Mayo Clinic, Rochester, USA says, "Despite providing important additional evidence about the clinical activity of vandetanib in DTC, [the study] leaves the important issue of the effect of vandetanib on overall survival unresolved."

He adds, "More work is needed to better clarify which patients with DTC might have the greatest net benefits from kinase inhibitors…and to develop individualised treatment approaches in DTC."

More information: Paper online: www.thelancet.com/journals/lan… (12)70335-2/abstract

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

US women's awareness of breast density varies

8 hours ago

Disparities in the level of awareness and knowledge of breast density exist among U.S. women, according to the results of a Mayo Clinic study published in the Journal of Clinical Oncology.

Study shows why some brain cancers resist treatment

8 hours ago

Scientists at The University of Texas MD Anderson Cancer Center may have discovered why some brain cancer patients develop resistance to standard treatments including radiation and the chemotherapy agent temozolomide.

Researchers identify genes responsible for lung tumors

10 hours ago

The lung transcription factor Nkx2-1 is an important gene regulating lung formation and normal respiratory functions after birth. Alterations in the expression of this transcription factor can lead to diseases such as lung ...

Lycopene may ward off kidney cancer in older women

11 hours ago

A higher intake by postmenopausal women of the natural antioxidant lycopene, found in foods like tomatoes, watermelon and papaya, may lower the risk of renal cell carcinoma, a type of kidney cancer.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.