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Drugs of interest to pathologists

Drugs related to surgical pathology

Vandetanib


Author: Him G. Kwee, M.D. (see Reviewers/Authors page)
Revised: 28 December 2011, last major update December 2011
Copyright: (c) 2011, PathologyOutlines.com, Inc.

General
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● A multi-kinase inhibitor

Trade name
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● Initially called Zactima by AstraZeneca, but in August 2011, changed to Caprelsa to avoid confusion with other drugs

Clinical information
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Approved by US Food and Drug Administration on April 6, 2011 for:
● Symptomatic or progressive unresectable locally advanced or metastatic medullary carcinoma of the thyroid (MCT)
● Released by the FDA with a REMS (Risk Evaluation and Mitigation Strategy) requirement (Caprelsa website, FDA News Drug Daily Bulletin)
● There are clinical trials using this drug for non-small cell lung carcinoma, in combination with other drugs

● Approximate cost: $11,880 per month in September 2011 (First Data Bank, Fallon Community Health Plan Pharmacy Services bulletin, September 7, 2011)

Use for pathologists
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● Vandetanib inhibits VEGFR-2 (vascular endothelial growth factor receptor), EGFR and RET-tyrosine kinase activity (RET means rearranged during transfection proto-oncogene)
● 25% of hereditary MCT cases are associated with RET mutations, but the efficacy of vandetanib is independent of the RET mutation status of MCT (National Cancer Institute, Cancer Bulletin, vol.8, no. 8, April 19, 2011)
● Vandetanib should not be used if there is hypocalcemia, hypokalemia, hypomagnesemia or in long QT interval syndrome, since it can cause life-threatening cardiac arrhythmias

Other side effects include:
● Hypothyroidism
● Reversible posterior leukoencephalopathy syndrome
● Acne, photosensitivity and Stevens-Johnson syndrome
● Interstitial lung disease
● Diarrhea with electrolyte imbalance (AstraZeneca news bulletin August 1, 2011)

End of Drugs > Drugs related to surgical pathology > Vandetanib


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