Abstract | PURPOSE: Metronomic oral vinorelbine (MOV) could be a treatment option for unfit patients with advanced non-small cell lung cancer (NSCLC) based on its safety profile and high patient compliance. METHODS: We retrospectively collected data on 270 patients [median age 76 (range 48-92) years, M/F 204/66, PS 0 (27)/1 (110)/≥ 2 (133), median of 3 serious comorbidities] with stage IIIB-IV NSCLC treated with MOV as first (T1) (67%), second (T2) (19%) or subsequent (T3) (14%) line. Schedules consisted of vinorelbine 50 mg (138), 40 mg (68) or 30 mg (64) three times a week continuously. RESULTS: Patients received an overall median of 6 (range 1-25) cycles with a total of 1253 cycles delivered. The overall response rate was 17.8% with 46 partial and 2 complete responses and 119 patients (44.1%) experienced stable disease > 12 weeks with an overall disease control rate of 61.9%. Median overall time to progression was 5 (range 1-21) months [T1 7 (1-21), T2 5.5 (1-19) and T3 4 (1-19) months] and median overall survival 9 (range 1-36) months [T1 10 (1-31), T2 8 (1-36) and T3 6.5 (2-29) months]. Treatment was extremely well tolerated with 2% (25/1253) G3/4 toxicity (mainly G3 fatigue and anemia) and no toxic deaths. We observed the longer OS 14 (range 7-36) months in a subset of squamous NSCLC patients receiving immunotherapy after metronomic oral vinorelbine. CONCLUSION: We confirmed MOV as an extremely safe treatment in a large real world population of advanced NSCLC with an interesting activity mainly consisting of long-term disease stabilization. We speculate the possibility of a synergistic effect with subsequent immunotherapy.
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Authors | A Camerini, G L Banna, S Cinieri, A Pezzuto, M Mencoboni, F Rosetti, A Figueiredo, P Rizzo, A Ricci, L Langenhoven, A Santo, A Addeo, D Amoroso, F Barata |
Journal | Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
(Clin Transl Oncol)
Vol. 21
Issue 6
Pg. 790-795
(Jun 2019)
ISSN: 1699-3055 [Electronic] Italy |
PMID | 30448956
(Publication Type: Journal Article, Multicenter Study)
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Chemical References |
- Antineoplastic Agents, Phytogenic
- Vinorelbine
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Topics |
- Adenocarcinoma
(drug therapy, pathology)
- Administration, Metronomic
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Phytogenic
(administration & dosage)
- Carcinoma, Large Cell
(drug therapy, pathology)
- Carcinoma, Non-Small-Cell Lung
(drug therapy, pathology)
- Carcinoma, Squamous Cell
(drug therapy, pathology)
- Female
- Follow-Up Studies
- Humans
- International Agencies
- Lung Neoplasms
(drug therapy, pathology)
- Male
- Middle Aged
- Palliative Care
- Remission Induction
- Retrospective Studies
- Survival Rate
- Vinorelbine
(administration & dosage)
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