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Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-.

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Aggressive thyroid cancer: What are the advantages or disadvantages of vandetanib (Caprelsa)?

Last Update: September 10, 2013.

man reading in the garden
Vandetanib (trade name Caprelsa) was approved in Germany in February 2012 for treating adults who have advanced medullary thyroid cancer. This drug is an option for people who have an aggressive and symptomatic course of disease.

If a malignant thyroid tumor is detected, it is common to surgically remove either the tumor or the entire thyroid gland. Yet sometimes surgery is no longer an option because the tumor is already very large or it has already produced secondary tumors in other parts of the body. If this is the case, the cancer is described as being in an advanced stage.

There are different types of thyroid cancer. The medullary form is relatively rare. In some people who have advanced medullary thyroid cancer, the tumor is more aggressive than in others, and it also causes typical symptoms such as pain, diarrhea or skin redness. The new drug vandetanib aims to slow tumor growth in these people. It is not known exactly how this drug works.

How is vandetanib used?

Depending on the recommended dosage, vandetanib is taken one to three times a day in tablet form. It should always be taken at around the same times of the day, and these times do not need to correspond to mealtimes.

What was vandetanib compared with?

Patients with aggressive and symptomatic advanced medullary thyroid cancer have usually been provided with supportive care up to now. This care may include pain therapy, and it ought to relieve symptoms as much as possible and improve quality of life.

In mid-2012, the German Institute for Quality and Efficiency in Health Care (IQWiG) was to assess how vandetanib compares with the supportive care.

IQWiG based this assessment on one suitable trial. All trial participants received supportive care, and two thirds also took vandetanib. This trial also included many people who had medullary thyroid cancer that was not aggressive and symptomatic, and the drug is not approved for that use. To be able to evaluate which advantages or disadvantages vandetanib has for the patients it is intended for, IQWiG would have needed a separate evaluation for that patient group. This information was not provided by the manufacturer, however.

What advantages or disadvantages does vandetanib have?

There was no evaluation of trial results for patients with aggressive and symptomatic advanced medullary thyroid cancer. It is therefore not clear what advantages or disadvantages vandetanib has for these people.

Where can I get more information?

This text summarizes the most important results of a review by the German Institute for Quality and Efficiency in Health Care (IQWiG) published in June 2012. You can read the entire review (in German) here on the IQWiG website.

The IQWiG review was commissioned by the German Federal Joint Committee (G-BA) as part of the “benefit assessment of pharmaceuticals pursuant to § 35a Social Code Book V”. In September 2012, G-BA passed a resolution on the benefit of vandetanib (Caprelsa) on the basis of this review and the hearings received. You can find out more about the background of the benefit assessment and the G-BA resolution here: www.g-ba.de (in German).

You can read more about the thyroid gland here:

Feature: “Thyroid

© IQWiG (Institute for Quality and Efficiency in Health Care)

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