CAPRELSA VANDETANIB 凡德他尼

Vandetanib is an oral multi-target tyrosine kinase inhibitor, mainly used to treat specific types of cancer such as medullary thyroid cancer. It blocks cancer cell proliferation and angiogenesis by inhibiting multiple signaling pathways related to tumor growth (such as RET, EGFR, VEGFR, etc.), thereby delaying disease progression.

1. Basic characteristics and mechanism of action of the drug

Vandetanib is a small molecule targeted drug, mainly targeting tyrosine kinases related to tumorigenesis. Its mechanism of action includes:

Inhibition of RET protein: About 95% of patients with medullary thyroid cancer have RET gene mutations. Vandetanib directly inhibits tumor growth by blocking the activity of this protein.

Anti-angiogenesis: By inhibiting vascular endothelial growth factor receptor (VEGFR), tumor blood vessel formation is reduced and the nutrient supply of cancer cells is cut off.

Blocking epidermal growth factor receptor (EGFR): Some cancers rely on the EGFR signaling pathway, and vandetanib can interfere with this process.
2. Indications and clinical applications
‌Medullary thyroid cancer‌: Suitable for patients with locally advanced or metastatic disease who cannot undergo surgery, especially those with RET gene mutations.
‌Other exploratory uses‌: Clinical trials have been conducted in solid tumors such as non-small cell lung cancer and colorectal cancer, but the efficacy has not yet been widely recognized.
Clinical studies have shown that vandetanib can significantly prolong the progression-free survival of patients with medullary thyroid cancer, and the tumor volume of some patients has shrunk. However, it should be noted that this drug cannot cure cancer and is mainly used to control the disease.

3. Common side effects and treatment recommendations
The side effects of vandetanib are similar to those of most targeted drugs, mainly including:

‌Mild reactions‌: rash, diarrhea, nausea, fatigue, etc., which can usually be relieved by adjusting the dose or symptomatic treatment.
‌Serious risks‌: ‌QT interval prolongation‌: May cause arrhythmia, and regular monitoring of electrocardiograms and electrolytes (such as potassium and calcium) is required.
‌Interstitial lung disease‌: Rare but potentially fatal, if breathing difficulties occur, stop the drug immediately and seek medical attention.
‌Hypertension‌: About 30% of patients have elevated blood pressure, which requires combined antihypertensive drug management.
IV. Precautions for use
‌Contraindications‌: Patients with severe heart disease (such as long QT syndrome), pregnant women and lactating women are prohibited.
‌Drug interactions‌: Avoid combined use with strong CYP3A4 inducers (such as rifampicin) or inhibitors (such as ketoconazole), which may affect blood drug concentrations.
‌Monitoring requirements‌: Check electrocardiogram, electrolytes and thyroid function every 2-3 months at the beginning of treatment, and the interval can be appropriately extended in the later stage.
V. Summary
As a ‌precision treatment drug‌, vandetanib provides an important treatment option for patients with medullary thyroid cancer, but the patient’s underlying disease and medication risks need to be strictly evaluated. Adverse reactions need to be closely monitored during treatment, and the regimen should be adjusted according to individual conditions. Patients should follow the doctor’s advice and avoid stopping the drug or changing the dose on their own to ensure a balance between efficacy and safety.