Vandetanib in Preventing Head and Neck Cancer in Patients With Precancerous Head and Neck Lesions

PRIMARY OBJECTIVE: I. Determine the effect of ZD6474 (vandetanib) compared to placebo on microvessel density (MVD) from baseline to 3 months in patients at risk for oral squamous cell carcinoma (OSCC) with preneoplastic lesions. SECONDARY OBJECTIVES: I. Change in MVD over 6 months. II. Change in putative targets of ZD6474: tissues will be analyzed by immunohistochemistry (IHC) for phosphorylated epidermal growth factor receptor (pEGFR), EGFR, phosphorylated-vascular endothelial growth factor receptor 2 (pVEGFR2), VEGFR2. III. Change in proliferative index as measured by Ki-67 IHC. IV. Safety, tolerability, and adherence to ZD6474 for 6 months in patients at risk for OSCC. TERTIARY OBJECTIVES: I. Compare OSCC incidence in both study arms (ZD6474 and placebo). OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive vandetanib orally (PO) once daily (QD) for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive placebo PO QD for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 9 and 12 months and then every 6 months for 2 years.