Can vandetanib prolong survival?

This review analyzed the efficacy and safety of vandetanib (Caprelsa) in combination with chemotherapy for the treatment of advanced non-small cell lung cancer.

Chemotherapy is often the standard of treatment for advanced non-small cell lung cancer (NSCLC). However, response rates to treatments, as well as survival, remain low. Vandetanib is a biological anti-cancer therapy often used in the treatment of the thyroid tumors. Vandetanib inhibits the action of certain proteins (called kinases) which are crucial for cancer growth and spread. Due to the successful use of vandetanib in other cancer types, recent trials have investigated its potential to treat NSCLC.

This review analyzed 5 trials, including a total of 2,284 patients diagnosed with advanced NSCLC. Response to treatment, side effects, overall survival and progression free survival (the length of time between treatment and until the disease worsens or progresses) were compared between patients receiving standard chemotherapy, to those receiving chemotherapy combined with vandetanib.

Compared to chemotherapy alone, the addition of vandetanib resulted in significantly longer progression free survival. The risk of early cancer progression was reduced by 21% among patients receiving vandetanib.  The chance of achieving a good response to treatment (as measured by tumor shrinkage) was 75% higher among patients receiving vandetanib. However, the addition of vandetanib to treatment showed only a non-significant advantage when regarding overall survival.

The combination of vandetanib with chemotherapy also increased the rate of adverse side effects such as skin rashes and diarrhea compared to chemotherapy alone. Interestingly, there was a significant reduction in the rate of anemia (low red blood cell count; a common side effect of chemotherapy) among patients receiving vandetanib.

The analysis concluded that vandetanib is safe and effective in the treatment of non-small cell lung cancer. Further investigation into which patients might benefit most from addition of vandetanib to chemotherapy is warranted.