Vandetanib Now Available to U.S. Patients with Advanced Medullary Thyroid Cancer

AstraZeneca (NYSE: AZN) today announced that the orphan drug vandetanib is now available to U.S. patients for the treatment of medullary thyroid cancer that cannot be removed by surgery or that has spread to other parts of the body. Vandetanib was approved by the U.S. Food and Drug Administration on April 6, 2011 and is available exclusively through the pharmacy business unit of Biologics, Inc., an integrated oncology management company.

Vandetanib is a kinase inhibitor indicated for the treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable (non-operable) locally advanced or metastatic disease. The use of vandetanib in patients with indolent, asymptomatic or slowly progressing disease should be carefully considered because of the treatment-related risks.

A Risk Evaluation and Mitigation Strategy (REMS) is required for vandetanib due to the risks of QT prolongation, Torsades de pointes, and sudden death. Only prescribers who are certified through the Vandetanib REMS Program, a restricted distribution program, will be able to prescribe vandetanib. To learn about the specific REMS requirements and to enroll in the Vandetanib REMS Program, health care professionals should call 1-800-236-9933 or visit www.vandetanibrems.com.

“Vandetanib is the only medicine specifically approved for patients with this rare form of cancer,” said Lisa Schoenberg, Vice President of Specialty Care, AstraZeneca. “We believe vandetanib will be important for the community of patients and doctors who are fighting this disease.”

AstraZeneca is working with relevant authorities on a trade name and is currently referring to the treatment by its generic name, vandetanib.

Important Safety Information, including boxed WARNING

WARNING: QT PROLONGATION, TORSADES DE POINTES, AND SUDDEN DEATH

• Vandetanib can prolong the QT interval. Torsades de pointes and sudden death have been reported in patients receiving vandetanib.
• Vandetanib should not be used in patients with hypocalcemia, hypokalemia, hypomagnesemia, or long QT syndrome. Hypocalcemia, hypokalemia and/or hypomagnesemia must be corrected prior to vandetanib administration and should be periodically monitored.
• Drugs known to prolong the QT interval should be avoided. If a drug known to prolong the QT interval must be administered, more frequent ECG monitoring is recommended.
• Given the half-life of 19 days, ECGs should be obtained to monitor the QT interval at baseline, at 2-4 weeks and 8-12 weeks after starting treatment with vandetanib and every 3 months thereafter. Following any dose reduction for QT prolongation, or any dose interruptions greater than 2 weeks, QT assessment should be conducted as described above.
• Because of the 19-day half-life, adverse reactions including a prolonged QT interval may not resolve quickly. Monitor appropriately.
• Only prescribers and pharmacies certified with the restricted distribution program are able to prescribe and dispense vandetanib.
• Do not use vandetanib in patients with congenital long QT syndrome.
• Because of the risk of QT prolongation, ECGs and levels of serum potassium, calcium, magnesium, and TSH should be monitored at baseline, at 2-4 weeks and 8-12 weeks after starting treatment with vandetanib, and every 3 months thereafter and following dose adjustments.
• Severe skin reactions (including Stevens-Johnson syndrome), some leading to death, have been reported and may prompt permanent discontinuation of vandetanib.
• Interstitial lung disease (ILD) has been observed with vandetanib and deaths have been reported. Interrupt vandetanib treatment and investigate unexplained dyspnea, cough, and fever.
• Ischemic cerebrovascular events, serious hemorrhagic events, and heart failure have been observed with vandetanib and some cases have been fatal.
• Diarrhea has been observed with vandetanib. Serum electrolytes and ECGs should be carefully monitored in cases of diarrhea because of the risk of QT prolongation with vandetanib. If severe diarrhea develops, vandetanib treatment should be stopped until diarrhea improves.
• Hypothyroidism, hypertension, and reversible posterior leukoencephalopathy syndrome (RPLS) have been observed with vandetanib.
• The concomitant use of known strong CYP3A4 inducers may reduce drug levels of vandetanib and should be avoided. The administration of vandetanib with antiarrhythmic drugs and other drugs that may prolong the QT interval should be avoided.
• Vandetanib exposure is increased in patients with impaired renal function. The starting dose of vandetanib should be reduced to 200 mg in patients with moderate to severe renal impairment and the QT interval should be monitored closely.
• Vandetanib is not recommended for patients with moderate and severe hepatic impairment, since safety and efficacy have not been established.
• Vandetanib can cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised to avoid pregnancy while receiving vandetanib and for at least 4 months following treatment.
• The most common adverse drug reactions (>20%) seen with vandetanib are diarrhea (57%), rash (53%), acne (35%), nausea (33%), hypertension (33%), headache (26%), fatigue (24%), decreased appetite (21%), and abdominal pain (21%). The most common laboratory abnormalities (>20%) were decreased calcium (57%), increased ALT (51%), and decreased glucose (24%).
• Vandetanib REMS Program: Because of the risks of QT prolongation, Torsades de pointes, and sudden death, vandetanib is available only through the Vandetanib REMS Program. Only prescribers and pharmacies certified with the restricted program are able to prescribe and dispense vandetanib. To learn about the specific REMS requirements and to enroll in the Vandetanib REMS Program call 1-800-236-9933 or visit www.vandetanibrems.com.

For further information on vandetanib, please see the full Prescribing Information including boxed WARNING, at http://www1.astrazeneca-us.com/pi/vandetanib.pdf.

NOTES TO EDITORS:

About AstraZeneca

AstraZeneca is a global, innovation-driven biopharmaceutical business with a primary focus on the discovery, development and commercialization of prescription medicines for gastrointestinal, cardiovascular, neuroscience, respiratory and inflammation, oncology and infectious disease. AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide.

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