2.1 Vandetanib (Caprelsa, Sanofi) is indicated for the 'treatment of aggressive and symptomatic medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease'. For patients in whom rearranged during transfection mutation status is not known or is negative, a possible lower benefit should be taken into account before individual treatment decisions.
Dosage in the marketing authorisation
2.2 300 mg taken orally once daily until disease progression or until the benefits of treatment continuation no longer outweigh its risk. Dose reductions of 200 mg or 100 mg are available if needed.
2.3 £5,000 per 30×300-mg pack, or £2,500 per 30×100-mg pack (excluding VAT; British national formulary July 2017). The company has a commercial arrangement, which would apply if the technology had been recommended.