# ZETA: vandetanib in locally advanced or metastatic medullary thyroid cancer

Source: https://onco.cc/key-papers/paper-zeta-vandetanib-mtc-wells-jco-2012/  
OnCo record `paper-zeta-vandetanib-mtc-wells-jco-2012` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Vandetanib was the first drug shown to delay progression in medullary thyroid cancer, roughly doubling progression-free survival compared with placebo, and became the first approved therapy for the disease.

## Summary

Phase 3 placebo-controlled trial of 331 patients with unresectable locally advanced or metastatic medullary thyroid cancer randomised 2:1 to vandetanib 300 mg daily or placebo.

Median progression-free survival was predicted at 30.5 versus 19.3 months (hazard ratio 0.46) with response 45 versus 13 percent (placebo responses reflecting slow disease and crossover); QT prolongation, diarrhoea and rash were the main toxicities.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Clinical Oncology
- Year: 2012
- DOI: 10.1200/JCO.2011.35.5040
- Authors: Wells SA, Robinson BG, Gagel RF, et al.
- Findings: Progression-free survival hazard ratio 0.46; predicted median 30.5 vs 19.3 months.; Objective response 45 percent vs 13 percent.
- What it means: Vandetanib is an approved option for progressive medullary thyroid cancer, used less since selpercatinib for RET-mutant disease.
- Caveats: Enrolled patients with indolent disease, some not progressing; QT monitoring required.

## Sources

- J Clin Oncol 2012: https://doi.org/10.1200/JCO.2011.35.5040
- PubMed: https://pubmed.ncbi.nlm.nih.gov/22025146/

## Connected records

- cancers: [Medullary thyroid cancer](https://onco.cc/cancers/medullary-thyroid-cancer/)
- drugs: [Vandetanib](https://onco.cc/drugs/vandetanib/)
- trials: [ZETA](https://onco.cc/trials/zeta/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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