Drug Formulary information is intended for use by healthcare professionals. It is not intended to be medical advice. Some of the information, including information about funding for cancer drugs, does not apply to all patients. Cancer treatment plans are unique to each patient. If you are a patient, please speak with your healthcare team to understand how this information applies to you.

regimen-monograph

VAND

Cancer Type
Endocrine, Thyroid
Intent
Palliative
Regimen Category
Evidence-Informed
Funding Program
Exceptional Access Program vanDETanib - Monotherapy for symptomatic and/or progressive medullary thyroid cancer (MTC), with specific criteria
Drugs Used
A - Regimen Name

VAND Regimen
Vandetanib


Disease Site
Endocrine
Thyroid


Intent
Palliative

Regimen Category
Evidence-Informed :

Regimen is considered appropriate as part of the standard care of patients; meaningfully improves outcomes (survival, quality of life), tolerability or costs compared to alternatives (recommended by the Disease Site Team and national consensus body e.g. pan-Canadian Oncology Drug Review, pCODR).  Recommendation is based on an appropriately conducted phase III clinical trial relevant to the Canadian context OR (where phase III trials are not feasible) an appropriately sized phase II trial. Regimens where one or more drugs are not approved by Health Canada for any indication will be identified under Rationale and Use.


Rationale and Uses

For the treatment of symptomatic and/or progressive medullary thyroid cancer in adult patients with unresectable locally advanced or metastatic disease

(Vandetanib can only be prescribed and dispensed by physicians and pharmacies under certification by the Caprelsa® restricted distribution program.)


Supplementary Public Funding

vanDETanib
Exceptional Access Program (vanDETanib - Monotherapy for symptomatic and/or progressive medullary thyroid cancer (MTC), with specific criteria)

 
B - Drug Regimen

Vandetanib can only be prescribed and dispensed by physicians and pharmacies under certification by the Caprelsa® restricted distribution program. Patients must be enrolled and comply with the requirements of this program before receiving vandetanib.
 

vanDETanib
300 mg PO Daily
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C - Cycle Frequency

CONTINUOUS TREATMENT

Until disease progression, no evidence of further response, or unacceptable toxicity.

 
D - Premedication and Supportive Measures

Antiemetic Regimen:

Minimal – No routine prophylaxis; PRN recommended


Screen for hepatitis B virus in all cancer patients starting systemic treatment. Refer to the hepatitis B virus screening and management guideline.
 

Other Supportive Care:

  • Patients taking vandetanib have a potential for photosensitivity upon sun exposure. Patients should wear protective clothing and/or sunblock (with an SPF of at least 30) during vandetanib treatment and for 4 months after the last dose.

  • Patients should be provided with loperamide and instructions on how to manage diarrhea.

 
E - Dose Modifications

Refer to vandetanib drug monograph(s) for details.

 
F - Adverse Effects

Refer to vandetanib drug monograph(s) for details.

 
G - Interactions

Refer to vandetanib drug monograph(s) for details.

 
H - Drug Administration and Special Precautions

Refer to vandetanib drug monograph(s) for details.

 
I - Recommended Clinical Monitoring

Treating physicians may decide to monitor more or less frequently for individual patients but should always consider recommendations from the product monograph.

Refer to the hepatitis B virus screening and management guideline for monitoring during and after treatment.
 

Recommended Clinical Monitoring

  • ECG and blood pressure; at baseline, 2-4 weeks and 8-12 weeks during treatment, and q3 months thereafter, also after dose adjustments

  • Electrolytes (including calcium, potassium, magnesium) and TSH; at baseline, 2-4 weeks and 8-12 weeks during treatment, then q3 months thereafter, also after dose adjustments

  • CBC; baseline and at each visit

  • Liver function tests; baseline and at each visit

  • Renal function tests; baseline and at each visit

  • Oral examination (monitoring for osteonecrosis of the jaw); baseline and as clinically indicated

  • Clinical toxicity assessment for rash, wound healing, diarrhea, hypertension, arterial/venous thromboembolism, bleeding, osteonecrosis (non-mandibular), neurologic, cardiovascular, ophthalmic and respiratory side effects; at each visit

  • Grade toxicity using the current NCI-CTCAE (Common Terminology Criteria for Adverse Events) version

Suggested Clinical Monitoring

  • Renal function tests; baseline and regular

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J - Administrative Information

Outpatient prescription for home administration


 
K - References

Vandetanib drug monograph, Ontario Health (Cancer Care Ontario).

Wells SA Jr, Robinson BG, Gage RF, et al.  Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind Phase III Trial.  J Clin Oncol 2012;30(2):134-41.

June 2026 Updated Supportive Care and Monitoring sections


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M - Disclaimer

Regimen Abstracts
A Regimen Abstract is an abbreviated version of a Regimen Monograph and contains only top level information on usage, dosing, schedule, cycle length and special notes (if available). It is intended for healthcare providers and is to be used for informational purposes only. It is not intended to constitute or be a substitute for medical advice, and all uses of the Regimen Abstract are subject to clinical judgment. Such information is provided on an “as-is” basis, without any representation, warranty, or condition, whether express, or implied, statutory or otherwise, as to the information’s quality, accuracy, currency, completeness, or reliability, and Cancer Care Ontario disclaims all liability for the use of this information, and for any claims, actions, demands or suits that arise from such use.
Information in regimen abstracts is accurate to the extent of the ST-QBP regimen master listings, and has not undergone the full review process of a regimen monograph.  Full regimen monographs will be published for each ST-QBP regimen as they are developed.
Regimen Monographs
Refer to the New Drug Funding Program or Ontario Public Drug Programs websites for the most up-to-date public funding information.
The information set out in the drug monographs, regimen monographs, appendices and symptom management information (for health professionals) contained in the Drug Formulary (the "Formulary") is intended for healthcare providers and is to be used for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects of a particular drug, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for a given condition. The information in the Formulary is not intended to constitute or be a substitute for medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.
The format and content of the drug monographs, regimen monographs, appendices and symptom management information contained in the Formulary will change as they are reviewed and revised on a periodic basis. The date of last revision will be visible on each page of the monograph and regimen. Since standards of usage are constantly evolving, it is advised that the Formulary not be used as the sole source of information. It is strongly recommended that original references or product monograph be consulted prior to using a chemotherapy regimen for the first time.
Some Formulary documents, such as the medication information sheets, regimen information sheets and symptom management information (for patients), are intended for patients. Patients should always consult with their healthcare provider if they have questions regarding any information set out in the Formulary documents.
While care has been taken in the preparation of the information contained in the Formulary, such information is provided on an “as-is” basis, without any representation, warranty, or condition, whether express, or implied, statutory or otherwise, as to the information’s quality, accuracy, currency, completeness, or reliability.
CCO and the Formulary’s content providers shall have no liability, whether direct, indirect, consequential, contingent, special, or incidental, related to or arising from the information in the Formulary or its use thereof, whether based on breach of contract or tort (including negligence), and even if advised of the possibility thereof. Anyone using the information in the Formulary does so at his or her own risk, and by using such information, agrees to indemnify CCO and its content providers from any and all liability, loss, damages, costs and expenses (including legal fees and expenses) arising from such person’s use of the information in the Formulary.


Last Updated: July 27, 2026