Using Cabozantinib and Vandetanib in Medullary Thyroid Cancer

Eric J. Sherman, MD, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, comments on the use of cabozantinib and vandetinib in medullary thyroid cancer.

Cabozantinib and vandetinib are both approved agents and work through similar mechanisms, as tyrosine kinase inhibitors of RET. Though these drugs target RET, which is important in medullary thyroid cancer, they also target VEGFR, EGFR, and MET.

Clinical Pearls I

Cabozantinib and vandetinib both showed benefit to progression-free survival in phase III trial vs placebo. The problem with medullary thyroid cancer, Sherman says, is that it is a slow-growing disease and can be treated with many other drugs. It is unknown if either drug can demonstrate true benefit to overall survival or quality of life.

• Cabozantinib and vandetanib are both approved tyrosine kinase inhibitors of RET
• Cabozantinib and vandetanib also target VEGFR, EGFR, and MET

Clinical Pearls II

• Cabozantinib and vandetanib both showed PFS benefit in phase III trials vs placebo
• It is unknown if either drug leads to any true benefit to overall survival or quality of life