One more fallen star--ZODIAC and its implications.

摘要

Dramatic improvements seen in patients with metastatic non-small-cell lung cancer (NSCLC) treated initially with gefitinib, erlotinib, and now with crizotinib have raised high hopes among patients, families, clinicians, investigators, and industry.～（1-3） Nearly a hundred new compounds are being tested in more than 650 clinical trials for patients with NSCLC. Although this might seem very promising, it is quite disheartening to see that a number of clinical trials with new drugs have failed to meet even the most modest endpoints. Vandetanib, an oral inhibitor targeting the tyrosine kinases of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor receptor (VEGFR), now joins this list. In this issue of The Lancet Oncology, Herbst and colleagues4 report the results of a phase 3 trial of docetaxel with and without vandetanib (ZODIAC). The combination of docetaxel and vandetanib showed a significantly superior progression-free survival (PFS) compared with docetaxel alone. However, the improvement in PFS was modest and was not accompanied by any improvement in overall survival.