Vandetanib Is Active in Previously Treated Non–Small Cell Lung Cancer
The combination of vandetanib plus Taxotere resulted in longer survival without cancer progression than Taxotere alone among patients with previously-treated non–small cell lung cancer (NSCLC). These findings were recently published in the journal TheLancet Oncology.
Lung cancer causes more cancer-related deaths in the United States than the next three most deadly cancers combined. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, comprising approximately 75–80% of all lung cancers.
Because many lung cancer patients experience poor treatment outcomes, researchers continue to explore new approaches to treatment, such as new targeted therapies. A targeted therapy is one that is designed to treat only the cancer cells and minimize damage to normal, healthy cells. Cancer treatments that “target” cancer cells may offer the advantage of reduced treatment-related side effects and improved outcomes.
Vandetanib is an investigational targeted therapy that is taken orally. It targets cell signaling pathways that influence tumor growth and spread, specifically those that involve the vascular endothelial growth factor receptor (VEGFR) and the epidermal growth factor receptor (EGFR). Previous studies have indicated that the combination of vandetanib plus Taxotere may result in longer survival without cancer progression than Taxotere alone among patients with previously-treated NSCLC. Based on these results, this larger Phase III study was designed to further define the role of vandetanib combined with Taxotere in NSCLC.
In this double-blind Phase III study, researchers evaluated 1,392 Stage IIIB-IV NSCLC patients who had progressed following initial treatment. Patients were randomized to receive either vandetanib plus Taxotere or a placebo plus Taxotere.
- Median progression-free survival was 4.0 months in the vandetanib/Taxotere arm and 3.2 months in the placebo/Taxotere arm.
- For women, the median progression-free survival was 4.6 months versus 4.2 months, respectively.
- At six months, 28% of the vandetanib/Taxotere arm and 22% of the placebo/Taxotere arm had not experienced disease progression.
- Overall survival was not significantly different between arms.
- 22.2% of patients in the vandetanib/Taxotere arm and 11.0% in the placebo/Taxotere arm experienced a treatment-related side effect that resulted in discontinuation of treatment.
- There were 42 (6%) treatment-related deaths in the vandetanib/Taxotere arm and 38 (6%) in the placebo/Taxotere arm.
The researchers concluded that the combination of vandetanib plus Taxotere resulted in longer survival without cancer progression than Taxotere alone among patients with previously-treated NSCLC. Slowing disease progression is associated with better control of the symptoms caused by lung cancer. In addition the researchers indicated that “to the best of our knowledge, vandetanib is the first oral targeted therapy in phase 3 trials to show significant evidence of additional efficacy when added to standard chemotherapy, in patients with previously treated NSCLC.”
 Herbst RS, Sun Y, Eberhardt W, et al. Vandetanib plus docetaxel versus docetaxel as second-line treatment for patients with advanced non-small-cell lung cancer (ZODIAC): a double-blind, randomised, phase 3 trial. Lancet Oncology [early online publication]. June 5, 2010.
 Heymach JV, Johnson BE, Prager D et al. Randomized, placebo-controlled Phase II study of vandetanib plus docetaxel in previously treated non-small cell lung cancer. Journal of Clinical Oncology. 2007;4270-4277.
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