Four RCTs were included (3,292 patients, range 127 to 1,391). All of the trials scored the maximum 5 on the Jadad scale, which indicated higher quality.
Compared with control, vandetanib was associated with a borderline statistically significant longer progression-free survival (HR 0.91, 95% CI 0.83 to 1.00; three RCTs; Ι²=42%) and a greater overall response rate (OR 1.49, 95% CI 1.04 to 2.14; four RCTs; Ι²=67%). There was no significant difference in overall survival (three RCTs).
There was no difference in adverse events in grade 3-4 neutropenia, diarrhoea, cough, fatigue, rash or nausea and vomiting. Vandetanib was associated with a statistically significantly lower risk of grade 3-4 anaemia (OR 0.39, 95% CI 0.22 to 0.67; two RCTs; Ι²=45%),
The authors reported that there was no evidence of publication bias.