Vandetanib resistance management

Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor arising from the parafollicular C cells of the thyroid. Pediatric cases of this cancer are associated with the diagnosis of multiple endocrine neoplasia, which is caused by mutations in the rearranged during transfection (RET) gene. Vandetanib is an oral receptor tyrosine kinase inhibitor approved to treat patients with progressive medullary thyroid cancer. Although it has a 50% response rate, most patients will eventually develop drug-resistant disease.

Clinical studies have shown that vandetanib treatment is associated with several adverse events, including diarrhea, hypertension, QTc prolongation and fatigue, but it is acceptable because adverse events are generally mild and easy to control. Patients are advised to interrupt vandetanib treatment until adverse events resolve, then treatment can be resumed but at a lower dose. The development of drug resistance is often due to the combined action of multiple signaling pathways. By combining vandetanib with other targeted drugs or chemotherapy drugs, multiple signaling pathways can be inhibited and the therapeutic effect can be improved. Although tyrosine kinase inhibitor therapy is less toxic than chemotherapy, serious adverse events require discontinuation of therapy. In addition, vandetanib, an inhibitor that blocks tumor growth, does not eliminate it.

The original drug vandetanib has not yet been marketed in China, so it is not included in medical insurance. The original drug specifications of vandetanib listed overseasThe price of each box of 300mg*30 tablets may be more than 30,000 yuan (the price may fluctuate due to the exchange rate). There is currently no generic drug of vandetanib produced and launched. For more drug information and specific prices, please consult the medical consultant of Yaode.