Adding Vandetanib to Platinum + Etoposide Not Effective for SCLC
Small cell lung cancer
The addition of vandetanib to a platinum agent and etoposide did not improve time to progression or overall survival in patients with newly diagnosed extensive-stage small cell lung cancer (SCLC), a study published in the journal Cancer has shown.1
Vandetanib is a kinase inhibitor of VEGFR, EGFR, and the RET-tyrosine kinase approved for the treatment of metastatic medullary thyroid cancer. Researchers hypothesized that angiogenesis inhibition by adding vandetanib to chemotherapy may improve clinical outcomes for patients with extensive-stage SCLC.
For the double-blind, phase 2 trial, investigators enrolled 66 patients with previously untreated disease and randomly assigned them 1:1 to receive cisplatin/carboplatin plus etoposide with vandetanib or placebo. Patients were treated for up to 4 cycles and did not receive maintenance therapy.
Median time to progression among evaluable patients was 5.62 months with vandetanib, etoposide, and a platinum compared with 5.68 months with chemotherapy and placebo (P =.9518).
Median overall survival was 13.24 months and 9.24 with vandetanib and placebo, respectively (P =.4577). There was also no significant difference in response rate or disease-control rate between the 2 treatment arms.
In terms of safety, patients treated with vandetanib reported higher rates of nonhematologic toxicity.
The study further revealed no association between VEGF polymorphisms and clinical outcomes.
Ultimately, these findings do not support continued investigation of vandetanib in an unselected population of patients with extensive SCLC.
1. Sanborn RE, Patel JD, Masters GA, et al. A randomized, double-blind, phase 2 trial of platinum therapy plus etoposide with or without concurrent vandetanib (ZD6474) in patients with previously untreated extensive-stage small cell lung cancer: Hoosier Cancer Research Network LUN06-113. Cancer. 2016 Sep 1. doi: 10.1002/cncr.30287. [Epub ahead of print]