ZETA: vandetanib in locally advanced or metastatic medullary thyroid cancer
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.
Overview
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.
- Progression-free survival hazard ratio 0.46; predicted median 30.5 vs 19.3 months.
- Objective response 45 percent vs 13 percent.
Vandetanib is an approved option for progressive medullary thyroid cancer, used less since selpercatinib for RET-mutant disease.
- Enrolled patients with indolent disease, some not progressing; QT monitoring required.
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