SHIRIN KAY O.

BUTA
MSMT-1
ADVANCED CLINICAL CHEMISTRY
November 17, 2019

A JOURNAL REVIEW ON:

VANDETANIB (100 MG) IN PATIENTS WITH LOCALLY ADVANCED OR METASTATIC HEREDITARY
MEDULLARY THYROID CANCER
Bruce G. Robinson, Luis Paz-Ares, Annetta Krebs, James Vasselli, and Robert Haddad
June 2010

Vandetanib, an oral medication is an FDA approved anti-tumor drug for Medullary

Thyroid Carcinoma, is one of the two drugs of choice for patients who do not consider surgery
and even after total thyroidectomy. On previous studies, 300mg dose of Vandetanib has always
been used, even with its strong adverse effects (grade 3 or even higher) such as diarrhea, rash,
nausea, hypertension, and headache causing a great number of 31 out of 230 patients who
discontinued the treatment (Samuel A. Wells Jr, Bruce G. Robinson et., al, 2010).
In this study, the medication dose used is reduced to 100mg/d, a much less toxic dose,
and results were observed after the treatment in patients with locally advanced or metastatic
MTC.
This study was composed of 19 eligible patients (13 males, six females; mean age 45),
who were previously histologically confirmed to have MEN2A, MEN2B, or familial MTC by either
germline RET mutation and have undergone prior thyroidectomy, were given 100mg of
Vandetanib orally every day until disease progression, unacceptable toxicity, or withdrawal of
consent. Their baseline Calcitonin and CEA levels were acquired before the start of treatment.
The study started in 2006, where they recruited 19 patients until 2007. During the data
cut-off, 11 patients were continuing to receive vandetanib 100 mg/d. The remaining patients
had discontinued initial treatment because of withdrawal of consent (n = 1), adverse events (n
= 3), or disease progression (n = 4). All four patients with disease progression entered
postprogression treatment with vandetanib 300 mg/d.
Among 19 patients who participated, 3 (16%) confirmed partial response with 42%
reduction from baseline in serum calcitonin, and the treatment had 43.4 – 87.4 % disease
control rate. The adverse effects manifested were milder than the 300mg dose, grading 1-2
only. Out of 19 patients, only two discontinued treatment because of renal insufficiency
secondary to hypertension.
In conclusion, Vandetanib 100 mg/d was well tolerated in the majority of patients in this
study and has clinical antitumor activity in patients with advanced or metastatic hereditary
MTC.