Advances in Therapy

, Volume 30, Issue 11, pp 945-966

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Vandetanib in Advanced Medullary Thyroid Cancer: Review of Adverse Event Management Strategies

  • Enrique GrandeAffiliated withServicio de Oncología Médica, Hospital Ramón y Cajal Email author 
  • , Michael C. KreisslAffiliated withDepartment of Nuclear Medicine, University Hospital of WuerzburgDepartment of Nuclear Medicine, Central Hospital of Augsburg
  • , Sebastiano FilettiAffiliated withDepartment of Internal Medicine and Medical Specialities, University of Rome “Sapienza”
  • , Kate NewboldAffiliated withThyroid Unit, Royal Marsden Hospital
  • , Walter ReinischAffiliated withDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna
  • , Caroline RobertAffiliated withDepartment of Medical Oncology, Dermatology Unit and INSERM U981, Gustave Roussy Institute, University of Paris-Sud
  • , Martin SchlumbergerAffiliated withDepartment of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Institute, University of Paris-Sud
  • , Lærke K. TolstrupAffiliated withDepartment of Oncology, Clinical Research Unit, Odense University Hospital
  • , Jose L. ZamoranoAffiliated withCardiology Service, Hospital Ramón y Cajal
    • , Jaume CapdevilaAffiliated withMedical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d’Hebron University Hospital, Autonomous University of Barcelona



Vandetanib has recently demonstrated clinically meaningful benefits in patients with unresectable, locally advanced or metastatic medullary thyroid cancer (MTC). Given the potential for long-term vandetanib therapy in this setting, in addition to treatment for disease-related symptoms, effective management of related adverse events (AEs) is vital to ensure patient compliance and maximize clinical benefit with vandetanib therapy.


This expert meeting-based review aims to summarize published data on AEs associated with vandetanib therapy and to provide clinicians with specific practical guidance on education, monitoring, and management of toxicities induced in patients treated with vandetanib in advanced and metastatic MTC. The content of this review is based on the expert discussions from a multidisciplinary meeting held in October 2012.


Characteristics, frequency, and risk data are outlined for a number of dermatological, cardiovascular, gastrointestinal, and general AEs related to vandetanib treatment. Preventive strategies, practical treatment suggestions, and points for clinical consideration are provided.


Good patient and team communication is necessary for the prevention, early detection, and management of AEs of vandetanib. Physicians, nurses, and other healthcare providers play a critical role in providing AE management and patient support to optimize outcomes with vandetanib in MTC.


Adverse effects Antineoplastic agents/adverse effects Cardiovascular Dermatology Medullary thyroid cancer Medullary thyroid carcinoma Patient safety Piperidines/therapeutic use Protein kinase inhibitors Thyroid neoplasms/drug therapy Vandetanib