title: Vandetanib in advanced medullary thyroid cancer: review of adverse event management strategies.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Servicio de Oncología Médica, Hospital Ramón y Cajal, Carretera de Colmenar Viejo Km. 9.100, 28034, Madrid, Spain, egrande@oncologiahrc.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: Grande
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kreissl
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Filetti
authors.forename: Kate
authors.initials: K
authors.lastname: Newbold
authors.forename: Walter
authors.initials: W
authors.lastname: Reinisch
authors.forename: Caroline
authors.initials: C
authors.lastname: Robert
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
authors.forename: Lærke K
authors.initials: LK
authors.lastname: Tolstrup
authors.forename: Jose L
authors.initials: JL
authors.lastname: Zamorano
authors.forename: Jaume
authors.initials: J
authors.lastname: Capdevila
mesh_terms: D018278:Carcinoma, Neuroendocrine; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D003875:Drug Eruptions / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D064420:Drug-Related Side Effects and Adverse Reactions / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018579:Patient Selection; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D011379:Prognosis; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D018570:Risk Assessment; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D010880:Piperidines; D011799:Quinazolines; C452423:vandetanib