When combined with standard chemotherapy, Vandetanib ( Zactima ) improves progression-free survival for patients with advanced non-small cell lung cancer.

The findings, presented at the American Society of Clinical Oncology's Annual Meeting, mark the first clinical benefit of a small molecule targeted agent and standard chemotherapy in combination for lung cancer.

Vandetanib is a dual inhibitor and targets the epidermal growth factor receptor ( EGFR ) and vascular endothelial growth factor receptor ( VEGFR ). It is the first single agent in lung cancer to target both receptors.

According to the American Cancer Society, lung cancer accounts for the most cancer-related deaths. In 2009, 219,440 are expected to be diagnosed and 159,390 will likely die from the disease.

The ZODIAC, ( Zactima in cOmbination with Docetaxel In non-smAll cell lung Cancer ) study enrolled 1,391 patients with non-small cell lung cancer from 198 Centers between 2006 and 2008; all had received chemotherapy previously. Participants were randomized to receive either Docetaxel and placebo, or Docetaxel and Vandetanib. The median follow-up was 12.8 months and the study's primary endpoint was progression-free survival.

Patients in the combination arm had a 21 percent reduction in disease progression, compared to those who received Docetaxel alone ( hazard ratio, HR=0.79 ), and their median progression-free survival was 17.3 weeks. In contrast, the median progression-free survival in the control arm was 14 weeks. While it trended positive, however, there was no statistical difference in overall survival in the two groups. There was a statistically significant improvement in the time to worsening of symptoms ( HR=0.77 ).

In terms of side effects, patients who received Vandetanib experienced more diarrhea, rash and neutropenia. However, they experienced less of the significant side effects - nausea, vomiting, and anemia - than those who received Docetaxel alone.

Source: University of Texas MD Anderson Cancer Center, 2009

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