Vandetanib

drug
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Also known as CaprelsaGNF-PF-2188NSC-744325NSC-760766ZactimaZD-64ZD-6474ZD6474SID50112766SID103905338SID124893338SID144206064SID170465617VANDETANIB (ZD6474)VandetinibVandetanibÊVandetanibÂ

Summary

Vandetanib (CHEMBL24828) is an approved small-molecule tyrosine kinase inhibitor (ATC L01EX04) targeting EGFR, KDR, and RET; indicated across 53 conditions including thyroid gland carcinoma and thyroid tumor; with CIViC clinical evidence for 8 variant-indication associations (e.g. RET Fusion in lung non-small cell carcinoma).

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: L01EX04
  • Targets: 3 (EGFR, KDR, RET)
  • Indications: 53 conditions
  • Clinical trials: 102
  • Precision-oncology evidence (CIViC): 8 variant–indication associations
  • Chemistry: 475.4 Da · C22H24BrFN4O2

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL24828
NameVandetanib
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID3081361
ChEBICHEBI:49960
ATCL01EX04
Molecular formulaC22H24BrFN4O2
Molecular weight475.4
InChIKeyUHTHHESEBZOYNR-UHFFFAOYSA-N

SMILES: CN1CCC(CC1)COC2=C(C=C3C(=C2)N=CN=C3NC4=C(C=C(C=C4)Br)F)OC

IUPAC name: N-(4-bromo-2-fluorophenyl)-6-methoxy-7-[(1-methylpiperidin-4-yl)methoxy]quinazolin-4-amine

ChEBI definition: A quinazoline that is 7-[(1-methylpiperidin-4-yl)methoxy]quinazoline bearing additional methoxy and 4-bromo-2-fluorophenylamino substituents at positions 6 and 4 respectively. Used for the treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.

Pharmacological roles (ChEBI): tyrosine kinase inhibitor, antineoplastic agent.

Also known as: Caprelsa, GNF-PF-2188, NSC-744325, NSC-760766, Vandetanib, Zactima, ZD-64, ZD-6474, ZD6474, GNF-Pf-2188, vandetanib, SID50112766

Parent form; salt/anhydrous children: CHEMBL533849

Patent coverage: 12,325 distinct patent families (42,230 SureChEMBL compound mentions), from 5 matched compound structure(s). One matched structure accounts for 35,115 (83%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
EGFRepidermal growth factor receptorInhibition6.5217.5%P00533
KDRkinase insert domain receptorInhibition81.1%P35968
RETret proto-oncogeneInhibition70.4%P07949

Broader ChEMBL bioactivity targets: 137 (assay-derived). Sample: Leucine-rich repeat serine/threonine-protein kinase 2, Nuclear receptor ROR-gamma, Hormonally up-regulated neu tumor-associated kinase, Receptor tyrosine-protein kinase erbB-2, 5-hydroxytryptamine receptor 2B, Tyrosine-protein kinase Fyn, Macrophage colony-stimulating factor 1 receptor, Tyrosine-protein kinase ABL1, Alpha-2A adrenergic receptor, Vascular endothelial growth factor receptor 1.

Bioactivity

ChEMBL activities: 499 potent at pChembl ≥ 5 of 512 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
FLT49.96IC500.11nMCHEMBL_ACT_24867122
RET9.89IC500.13nMCHEMBL_ACT_24867102
SRC9.1IC500.79nMCHEMBL_ACT_24789092
KDR8.4IC504nMCHEMBL_ACT_24867256
RET8.4IC504nMCHEMBL_ACT_27908483
KDR8.38AC504.2nMCHEMBL_ACT_25167978
RIPK28.34Kd4.6nMCHEMBL_ACT_2907550
RIPK28.34Kd4.6nMCHEMBL_ACT_7578574
EGFR8.32Kd4.8nMCHEMBL_ACT_2898732
EGFR8.32Kd4.8nMCHEMBL_ACT_7580571
EGFR8.23Kd5.9nMCHEMBL_ACT_2898808
EGFR8.23Kd5.9nMCHEMBL_ACT_7580573
KDR8.2Ki6.31nMCHEMBL_ACT_9630093
RET8.15IC507nMCHEMBL_ACT_24867251
EGFR8.1Kd7.9nMCHEMBL_ACT_2898884
EGFR8.1Kd7.9nMCHEMBL_ACT_7580575
EGFR8.06Kd8.7nMCHEMBL_ACT_2904706
EGFR8.06Kd8.7nMCHEMBL_ACT_7580577
KDR8.05IC509nMCHEMBL_ACT_1516652
RET8.05IC509nMCHEMBL_ACT_22952710
EGFR8.05Kd8.9nMCHEMBL_ACT_2898922
ABL18.05Kd9nMCHEMBL_ACT_7580564
EGFR8.05Kd8.9nMCHEMBL_ACT_7580576
EGFR8.02Kd9.5nMCHEMBL_ACT_19218710
EGFR8.02Kd9.5nMCHEMBL_ACT_2898694
EGFR8.02Kd9.6nMCHEMBL_ACT_2898770
EGFR8.02Kd9.5nMCHEMBL_ACT_7580570
EGFR8.02Kd9.6nMCHEMBL_ACT_7580572
EGFR8.01AC509.8nMCHEMBL_ACT_25168844
ABL18.01Kd9.8nMCHEMBL_ACT_7580557

Target pathways

Aggregated over 3 target gene(s): EGFR, KDR, RET.

Top Reactome pathways

48 total, by targets touching each:

PathwayTargetsGenes
RAF/MAP kinase cascade2EGFR, RET
Signaling by ERBB21EGFR
Constitutive Signaling by Ligand-Responsive EGFR Cancer Variants1EGFR
Signaling by ERBB41EGFR
SHC1 events in ERBB2 signaling1EGFR
PLCG1 events in ERBB2 signaling1EGFR
PIP3 activates AKT signaling1EGFR
Signaling by EGFR1EGFR
GRB2 events in EGFR signaling1EGFR
GAB1 signalosome1EGFR
SHC1 events in EGFR signaling1EGFR
EGFR downregulation1EGFR
Neuropilin interactions with VEGF and VEGFR1KDR
VEGF binds to VEGFR leading to receptor dimerization1KDR
GRB2 events in ERBB2 signaling1EGFR
PI3K events in ERBB2 signaling1EGFR
EGFR interacts with phospholipase C-gamma1EGFR
Integrin cell surface interactions1KDR
EGFR Transactivation by Gastrin1EGFR
Constitutive Signaling by Aberrant PI3K in Cancer1EGFR
VEGFA-VEGFR2 Pathway1KDR
Signal transduction by L11EGFR
VEGFR2 mediated cell proliferation1KDR
Constitutive Signaling by EGFRvIII1EGFR
Inhibition of Signaling by Overexpressed EGFR1EGFR
ERBB2 Regulates Cell Motility1EGFR
PI5P, PP2A and IER3 Regulate PI3K/AKT Signaling1EGFR
ERBB2 Activates PTK6 Signaling1EGFR
RET signaling1RET
Cargo recognition for clathrin-mediated endocytosis1EGFR

Dominant GO biological processes

GO termTargets
positive regulation of cell migration3
positive regulation of MAPK cascade3
positive regulation of phosphatidylinositol 3-kinase/protein kinase B signal transduction3
protein phosphorylation3
cell surface receptor protein tyrosine kinase signaling pathway3
positive regulation of protein phosphorylation2
signal transduction2
positive regulation of cell population proliferation2
neuron differentiation2
negative regulation of apoptotic process2
epithelial cell proliferation2
positive regulation of epithelial cell proliferation2
positive regulation of ERK1 and ERK2 cascade2
MAPK cascade2
cell morphogenesis1

Indications & clinical

Indications

53 indications (7 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

IndicationTrial phaseMONDOEFO
thyroid gland carcinoma4MONDO:0015075EFO:0002892
thyroid tumor4MONDO:0015074EFO:0003841
neoplasm4MONDO:0005070EFO:0000616
thyroid gland papillary carcinoma4MONDO:0005075EFO:0000641
non-small cell lung carcinoma3MONDO:0005233EFO:0003060
lung neoplasm3MONDO:0021117MONDO:0008903
mesothelioma2MONDO:0005065EFO:0000588
exocrine pancreatic carcinoma2MONDO:0005192EFO:0002618
prostate carcinoma2MONDO:0005159EFO:0001663
hepatocellular carcinoma2MONDO:0007256EFO:0000182
clear cell renal carcinoma2MONDO:0005005EFO:0000349
head and neck squamous cell carcinoma2MONDO:0010150EFO:0000181
acute myeloid leukemia2MONDO:0018874EFO:0000222
colorectal adenocarcinoma2MONDO:0005008EFO:0000365
glioblastoma2MONDO:0018177EFO:0000519
oligoastrocytoma2MONDO:0016702EFO:0000630
small cell lung carcinoma2MONDO:0008433EFO:0000702
plasma cell myeloma2MONDO:0009693EFO:0001378
anaplastic astrocytoma2MONDO:0016684EFO:0002499
anaplastic oligodendroglioma2MONDO:0016696EFO:0002501
breast neoplasm2MONDO:0021100EFO:0003869
head and neck cancer2MONDO:0005627EFO:0006859
gliosarcoma2MONDO:0016681EFO:1001465
thyroid gland follicular carcinoma2MONDO:0005034EFO:0000501
gastric neoplasm2MONDO:0021085MONDO:0001056
peritoneal neoplasm2MONDO:0006901MONDO:0002087
fallopian tube neoplasm2MONDO:0021092MONDO:0002158
kidney cancer2MONDO:0002367MONDO:0002367
ovarian cancer2MONDO:0008170MONDO:0008170
ureter cancer2MONDO:0008627MONDO:0008627
gastrointestinal stromal tumor2MONDO:0011719MONDO:0011719
colorectal neoplasm2MONDO:0005335EFO:0004142
neuroblastoma1MONDO:0005072EFO:0000621
carcinoma of esophagus1MONDO:0019086EFO:0002916
diffuse intrinsic pontine glioma1MONDO:0006033EFO:1000026
central nervous system neoplasm1MONDO:0006130EFO:1000158
rectal cancer1MONDO:0006519EFO:1000657
glioma1MONDO:0021042MONDO:0100342
adrenal gland pheochromocytoma1MONDO:0004974EFO:0000239
carcinoma1MONDO:0004993EFO:0000313
paraganglioma1MONDO:0000448EFO:1000453
adenocarcinoma1MONDO:0004970MONDO:0003219

11 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 102.

Phase distribution

PhaseTrials
PHASE249
PHASE133
PHASE39
PHASE1/PHASE26
Not specified4
PHASE41

Top trials by phase / activity

NCTPhaseStatusTitle
NCT01496313PHASE4COMPLETEDTo Compare The Effects Of Two Doses Of Vandetanib In Patients With Advanced Medullary Thyroid Cancer
NCT04211337PHASE3ACTIVE_NOT_RECRUITINGA Study of Selpercatinib (LY3527723) in Participants With RET-Mutant Medullary Thyroid Cancer
NCT00312377PHASE3COMPLETEDZACTIMA (an Anti-EGFR / Anti-VEGF Agent) Combined With Docetaxel Compared to Docetaxel in Non-small Cell Lung Cancer
NCT00364351PHASE3COMPLETEDEfficacy Trial Comparing ZD6474 With Erlotinib in NSCLC After Failure of at Least One Prior Chemotherapy
NCT00404924PHASE3COMPLETEDZD6474 (ZACTIMA™) Phase III Study in EGFR Failures
NCT00410761PHASE3COMPLETEDAn Efficacy Study Comparing ZD6474 to Placebo in Medullary Thyroid Cancer
NCT00418886PHASE3COMPLETEDEfficacy Study Comparing ZD6474 in Combination With Pemetrexed and Pemetrexed Alone in 2nd Line NSCLC Patients
NCT01298323PHASE3COMPLETEDStudy to Determine if Contacting Patients With MTC More Frequently Results in Earlier Detection and Treatment of Signs and Symptoms of AEs and Thus a Decrease in the Percentage of Time Patients Experience AEs During First 12 Months on Vandetanib Treatment
NCT01876784PHASE3COMPLETEDEvaluation of Efficacy, Safety of Vandetanib in Patients With Differentiated Thyroid Cancer
NCT04760288PHASE3WITHDRAWNA Study of Pralsetinib Versus Standard of Care (SOC) for Treatment of RET-Mutated Medullary Thyroid Cancer (MTC).
NCT02299999PHASE2ACTIVE_NOT_RECRUITINGSAFIR02_Breast - Efficacy of Genome Analysis as a Therapeutic Decision Tool for Patients With Metastatic Breast Cancer
NCT06482086PHASE2RECRUITINGEfficacy of Organoid-Based Drug Screening to Guide Treatment for Locally Advanced Thyroid Cancer
NCT00034918PHASE2COMPLETEDThis Study is to Assess the Efficacy and Safety of ZD6474 in Subjects With Metastatic Breast Cancer
NCT00047788PHASE2COMPLETEDEfficacy Study of ZD6474 to Treat Multiple Myeloma Cancer
NCT00047840PHASE2COMPLETEDThis Study is to Assess the Efficacy and Safety of ZD6474 in Subjects With Non-small Cell Lung Cancer.
NCT00059722PHASE2COMPLETEDThis Study is to Compare the Efficacy of ZD6474 and ZD1839 in Subjects With NSCLC.
NCT00066313PHASE2COMPLETEDZD6474 in Treating Patients With Small Cell Lung Cancer
NCT00071188PHASE2COMPLETEDZD6474 Alone or in Combination With Paclitaxel and Carboplatin in Subjects With Previously Untreated Locally Advanced or Metastatic Non-small Cell Lung Cancer (NSCLC)
NCT00098345PHASE2COMPLETEDEfficacy and Tolerability of ZD6474 in Patients With Thyroid Cancer
NCT00290537PHASE2TERMINATEDPhase II Study of ZD6474 in Advanced NSCLC
NCT00358956PHASE2COMPLETEDA Study To Assess ZD6474 (ZACTIMA™) Monotherapy In Locally Advanced or Metastatic Hereditary Medullary Thyroid Cancer
NCT00402896PHASE2TERMINATEDMalignant Pleural Effusion With ZD6474
NCT00410189PHASE2COMPLETEDBATTLE Program: ZD6474 in Previously Treated Subjects With NSCLC
NCT00441142PHASE1/PHASE2COMPLETEDZactima With Temodar During Radiation Treatment for Newly Diagnosed Stage IV Brain Tumors
NCT00445549PHASE2TERMINATEDVandetanib to Treat Women With Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
NCT00454116PHASE2COMPLETEDA Phase II, Double Blind Study of 2 Doses of ZACTIMA™(ZD6474) in Combination With FOLFIRI vs FOLFIRI Alone for the Treatment of Colorectal Cancer in Patients
NCT00459043PHASE2COMPLETEDDocetaxel in Combination With Zactima (ZD6474) in Patients With Locally Advanced Squamous Cell Carcinoma of the the Head and Neck
NCT00459121PHASE2TERMINATEDVandetanib, Carboplatin, and Paclitaxel in Treating Patients With Stage I, Stage II, or Stage III Non-Small Cell Lung Cancer That Can Be Removed by Surgery
NCT00481845PHASE2TERMINATEDPhase 2 Anastrozole and Vandetanib (ZD6474) in Neoadjuvant Treatment of Postmenopausal Hormone Receptor-Positive Breast Cancer
NCT00494481PHASE2COMPLETEDE3 Breast Cancer Taxotere Combination
NCT00498797PHASE2COMPLETEDE3-Hormone Refractory Prostrate Cancer Taxotere Combination
NCT00500292PHASE2COMPLETEDA Phase II Study of 2 Doses of ZD6474 (Vandetanib) in Combination With FOLFOX vs FOLFOX Alone for the Treatment of Colorectal Cancer
NCT00508001PHASE2COMPLETEDPhase II Study of Best Support Care (BSC) Plus ZD6474(Vandetanib) in Patients With Inoperable Hepatocellular Carcinoma (HCC)
NCT00514046PHASE1/PHASE2COMPLETEDVandetanib to Treat Children and Adolescents With Medullary Thyroid Cancer
NCT00537095PHASE2COMPLETEDEfficacy and Safety of Vandetanib (ZD6474) in Patients With Metastatic Papillary or Follicular Thyroid Cancer
NCT00597116PHASE2TERMINATEDAn Efficacy and Safety Study With Vandetanib to Treat Inoperable or Relapsed Malignant Mesothelioma
NCT00613626PHASE2COMPLETEDCisplatin + Etoposide +/- Concurrent ZD6474 in Previously Untreated Extensive Stage Small Cell Lung Cancer
NCT00659438PHASE2COMPLETEDEfficacy and Safety of Zactima™ in Patients With Castration-refractory Metastatic Prostate Cancer
NCT00683787PHASE2TERMINATEDDocetaxel With or Without Vandetanib in Treating Patients With Metastatic Stomach Cancer or Gastroesophageal Junction Cancer
NCT00686036PHASE2TERMINATEDTrial Assessing Zactima Against Placebo in Prostate Cancer Subjects Undergoing Intermittent Androgen Deprivation Hormonal Therapy

Clinical evidence (CIViC)

Variant × indication × effect (8 predictive associations from 9 curated evidence items):

VariantIndicationEffectTherapyLevelCIViC
RET FusionLung Non-small Cell CarcinomaSensitivity/ResponseVandetanibCIViC BEID4848 +1
SDHB MutationHereditary Renal Cell CarcinomaSensitivity/ResponseVandetanib + MetforminCIViC BEID7959
AKT2 AmplificationLung AdenocarcinomaSensitivity/ResponseVandetanib + EverolimusCIViC CEID1621
KIF5B::RET FusionLung AdenocarcinomaSensitivity/ResponseEverolimus + VandetanibCIViC CEID1622
KIF5B::RET FusionLung AdenocarcinomaSensitivity/ResponseVandetanibCIViC CEID698
RET OverexpressionEstrogen-receptor Negative Breast CancerSensitivity/ResponseVandetanibCIViC DEID2992
RET OverexpressionBreast CancerSensitivity/ResponseVandetanibCIViC DEID740
KIF5B::RET Fusion AND RET G810ALung Non-small Cell CarcinomaResistanceVandetanibCIViC DEID4852

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline, but PharmGKB curates 0 clinical and 3 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

282 molecules share ≥1 primary target. Top 60 by shared-target count:

MoleculeSourceStatusShared targets
AFATINIBChEMBL + PubChemPhase 4 (approved)EGFR, KDR, RET
CRIZOTINIBChEMBL + PubChemPhase 4 (approved)EGFR, KDR, RET
GEFITINIBChEMBL + PubChemPhase 4 (approved)EGFR, KDR, RET
PazopanibChEMBL + PubChemPhase 4 (approved)EGFR, KDR, RET
SELUMETINIBChEMBL + PubChemPhase 4 (approved)EGFR, KDR, RET
ALECTINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
AXITINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
BRIGATINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
CABOZANTINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
CERITINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
DASATINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
ERLOTINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
FEDRATINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
IBRUTINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
MIDOSTAURINChEMBLPhase 4 (approved)EGFR, KDR, RET
PONATINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
SORAFENIBChEMBLPhase 4 (approved)EGFR, KDR, RET
SUNITINIBChEMBLPhase 4 (approved)EGFR, KDR, RET
VEMURAFENIBChEMBLPhase 4 (approved)EGFR, KDR, RET
ALISERTIBChEMBLPhase 3EGFR, KDR, RET
BARASERTIBChEMBLPhase 3EGFR, KDR, RET
BRIVANIBChEMBLPhase 3EGFR, KDR, RET
CANERTINIBChEMBLPhase 3EGFR, KDR, RET
CEDIRANIBChEMBLPhase 3EGFR, KDR, RET
DOVITINIBChEMBLPhase 3EGFR, KDR, RET
LESTAURTINIBChEMBLPhase 3EGFR, KDR, RET
LINIFANIBChEMBLPhase 3EGFR, KDR, RET
MOTESANIBChEMBLPhase 3EGFR, KDR, RET
QUERCETINChEMBLPhase 3EGFR, KDR, RET
SARACATINIBChEMBLPhase 3EGFR, KDR, RET
VATALANIBChEMBLPhase 3EGFR, KDR, RET
AEE-788ChEMBLPhase 2EGFR, KDR, RET
BEMCENTINIBChEMBLPhase 2EGFR, KDR, RET
CENISERTIBChEMBLPhase 2EGFR, KDR, RET
CEP-32496ChEMBLPhase 2EGFR, KDR, RET
DEFOSBARASERTIBChEMBLPhase 2EGFR, KDR, RET
DORAMAPIMODChEMBLPhase 2EGFR, KDR, RET
FORETINIBChEMBLPhase 2EGFR, KDR, RET
ILORASERTIBChEMBLPhase 2EGFR, KDR, RET
OSI-632ChEMBLPhase 2EGFR, KDR, RET
R-406ChEMBLPhase 2EGFR, KDR, RET
SU-014813ChEMBLPhase 2EGFR, KDR, RET
TOZASERTIBChEMBLPhase 2EGFR, KDR, RET
BinimetinibPubChemApprovedEGFR, KDR, RET
DACOMITINIBChEMBL + PubChemPhase 4 (approved)EGFR, RET
GENTIAN VIOLETChEMBL + PubChemPhase 4 (approved)EGFR, KDR
REGORAFENIBChEMBL + PubChemPhase 4 (approved)KDR, RET
SELPERCATINIBChEMBL + PubChemPhase 4 (approved)KDR, RET
ABEMACICLIBChEMBLPhase 4 (approved)EGFR, KDR
ACALABRUTINIBChEMBLPhase 4 (approved)EGFR, KDR
BOSUTINIBChEMBLPhase 4 (approved)EGFR, RET
ENTRECTINIBChEMBLPhase 4 (approved)KDR, RET
GILTERITINIBChEMBLPhase 4 (approved)EGFR, RET
HEXACHLOROPHENEChEMBLPhase 4 (approved)EGFR, KDR
IMATINIBChEMBLPhase 4 (approved)EGFR, KDR
INFIGRATINIBChEMBLPhase 4 (approved)KDR, RET
LAPATINIBChEMBLPhase 4 (approved)EGFR, RET
LENVATINIBChEMBLPhase 4 (approved)KDR, RET
NERATINIBChEMBLPhase 4 (approved)EGFR, KDR
NICLOSAMIDEChEMBLPhase 4 (approved)EGFR, KDR