Vandetanib Treatment in Patients with Metastatic Thyroid Medullary Carcinoma: Single Center Experience

Abstract

Medullary thyroid carcinomas (MTC) are neuroendocrine tumors that originate from the parafollicular C cells of the thyroid gland and accounts for 5% of thyroid cancers. In our study, we aimed to evaluate the drug tolerance, adverse events and the contribution of treatment to progression in patients followed-up with the diagnosis of metastatic MTC and treated with vandetanib in our clinic. The files of 6 patients who were treated with vandetanib in our center were examined and their data were evaluated. Skin eruptions were the most common adverse event with vandetanib treatment. Elevated liver enzymes and diarrhea were other observed adverse events. Drug treatment was interrupted for twelve weeks in 4 of 5 patients who developed skin eruptions. After twelve weeks, treatment was restarted from low dose. Treatment revision was performed in one patient due to severe skin eruptions. Stable disease was reported in 4 patients receiving vandetanib treatment, and progression in 1 patient. One of our patients with progression and brain metastases died due to infection. One patient could not continue treatment because of severe skin reactions after the usage of vandetanib for 2 months and the patient could not be evaluated in terms of progression. In metastatic and / or localized advanced MTCs, vandetanib, which is known to prolong the disease-free survival period, is a treatment option that can be preferred considering the known adverse event profile. It is important to inform patients who use vandetanib about treatment related adverse events to monitor them carefully and to provide supportive therapy in case of adverse events.

Keywords

• Medullary thyroid carcinomas
• vandetanib
• adverse events

Metastatik Tiroid Medüller Karsinom Olgularında Vandetanib Tedavisi: Tek Merkez Deneyimi

Abstract

Medüller tiroid karsinomları (MTK) tiroid bezinin parafoliküler C hücrelerinden köken alan ve tüm tiroid kanserlerinin %5’ini oluşturan kanserlerdir. Bu çalışmada metastatik MTK tanısıyla takipli olan ve vandetanib tedavisi uygulanan hastaların ilaç uyumu, ortaya çıkan yan etkiler ve tedavinin progresyona katkısını değerlendirmeyi amaçladık. Merkezimizde takipli ve vandetanib tedavisi verilen 6 hastanın dosya-ları incelenerek verileri değerlendirildi. Vandetanib tedavisi ile en sık izlenen yan etki cilt döküntüleriydi. Karaciğer enzim yüksekliği ve diyare diğer gözlemlenen yan etkilerdi. Cilt döküntüleri gelişen 5 hastanın 4’ünde ilaç tedavisine 12 hafta ara verildi. Dört hafta takip sonra-sında düşük doz ile tedaviye tekrar başlandı. Bir hastada ciddi cilt döküntüleri nedeniyle tedavi revizyonu yapıldı. Vandetanib tedavisi alan 4 hastada stabil hastalık, 1 hastada progresyon kaydedildi. Progresyon tespit edilen ve beyin metastazları olan bir hastamız enfeksiyon nedeniy-le ex oldu. Bir hastada ise 2 ay vandetanib kullanımı sonrasında ciddi cilt reaksiyonları geliştiğinden tedaviye devam edilemedi ve bu hasta değerlendirmeye alınamadı. Metastatik ve/veya lokalize ilerlemiş MTK’lerde hastalıksız sağ kalım süresini uzattığı bilinen vandetanib, bilinen yan etki profili de göz önüne alınarak tercih edilebilecek bir tedavi seçeneğidir. Vandetanib kullanan hastaların bilgilendirilmesi, dikkatli izlemi ve yan etki gelişmesi durumunda destek tedavisinin verilmesi önem taşımaktadır.

Keywords

• Medüller tiroid karsinomları
• vandetanib
• yan etki

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