# Vandetanib

Source: https://onco.cc/drugs/vandetanib/  
OnCo record `vandetanib` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Vandetanib was the first drug approved for medullary thyroid cancer (2011), now largely replaced by RET-selective selpercatinib.

## Summary

Vandetanib is a multi-kinase inhibitor of RET, VEGFR2 and EGFR, given at 300 mg once daily. It was the first drug approved for medullary thyroid cancer (April 2011), for symptomatic or progressive disease, after the ZETA trial showed a PFS hazard ratio of 0.46 versus placebo. Approval came with a REMS programme because QT prolongation requires ECG and electrolyte monitoring. LIBRETTO-531 then showed the RET-selective selpercatinib was superior first line to vandetanib or cabozantinib (PFS HR 0.28, 12-month PFS 86.8% versus 65.7%) with fewer grade 3 or higher adverse events (52.8% versus 76.4%), so vandetanib is now largely replaced. Its remaining role is in patients who cannot access or tolerate selective RET inhibitors. For a newcomer, it is the original medullary thyroid cancer pill, superseded by a drug built specifically for RET.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Caprelsa
- Modality: Small-molecule kinase inhibitor (RET, VEGFR, EGFR)
- Mechanism: Multikinase inhibitor of RET, VEGFR2, and EGFR.
- Approvals: US 2011: Symptomatic or progressive medullary thyroid cancer
- Dosing: Oral; 300 mg once daily

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Vandetanib
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Vandetanib

## Connected records

- cancers: [Medullary thyroid cancer](https://onco.cc/cancers/medullary-thyroid-cancer/), [Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)](https://onco.cc/cancers/multiple-endocrine-neoplasia/), [Multiple endocrine neoplasia type 2 (MEN2A and MEN2B)](https://onco.cc/cancers/men2-syndrome/), [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- technologies: [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/), [Thyroglobulin, calcitonin and CEA in thyroid cancer follow-up](https://onco.cc/technologies/thyroid-cancer-markers/)
- targets: [EGFR](https://onco.cc/targets/egfr/), [RET](https://onco.cc/targets/ret/), [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- companies: [Sanofi](https://onco.cc/companies/sanofi/)
- trials: [LIBRETTO-531](https://onco.cc/trials/libretto-531/), [ZETA](https://onco.cc/trials/zeta/)
- key papers: [ZETA: vandetanib in locally advanced or metastatic medullary thyroid cancer](https://onco.cc/key-papers/paper-zeta-vandetanib-mtc-wells-jco-2012/)
- pathways: [Thyroid cancer (KEGG map)](https://onco.cc/pathways/thyroid-cancer-signalling/)

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