Vinorelbine
Vinorelbine was tested in one study in 2001. 29 patients were given vinorelbine alone. 6 (24%) patients’ mesothelioma improved and 16 (55%) patients’ disease remained stable. This led to further trials using this drug. Journal of Clinical Oncology, Vol 18, Issue 23 (December), 2000: 3912-3917
© 2000 American Society for Clinical Oncology
One trial called MS-01 comparing active symptom control (ASC) with ASC and vinorelbine and with ASC, mitomycin, vinblastine, and cisplatin did not find any significant benefit for vinorelbine alone or the combination. Lancet. 2008 May 17;371(9625):1685-1694.
Gemcitabine and vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma.
Zucali PA, Ceresoli GL, Garassino I, De Vincenzo F, Cavina R, Campagnoli E, Cappuzzo F, Salamina S, Soto Parra HJ, Santoro A.
Department of Medical Oncology and Hematology, Humanitas Clinical Institute of Rozzano, Milan, Italy. paolo.zucali@humanitas.it
BACKGROUND: Pemetrexed-cisplatin chemotherapy is the standard of care in the first-line treatment of unresectable malignant pleural mesothelioma (MPM). Second-line cytotoxic therapy is considered for a growing group of patients, but the optimal treatment has not been defined to date. Gemcitabine and vinorelbine have shown activity in the first-line setting. The objective of this study was to evaluate the activity and toxicity of the gemcitabine-vinorelbine combination in pemetrexed-pretreated patients with MPM. METHODS: From January 2004 to September 2006, 30 consecutive patients who were pretreated with pemetrexed with or without a platinum-derivative were enrolled. Gemcitabine 1000 mg/m(2) and vinorelbine 25 mg/m(2) were administered intravenously on Days 1 and 8 every 3 weeks. Treatment was repeated for a maximum of 6 cycles or until progression or unacceptable toxicity. RESULTS: A partial response was observed in 3 patients (10%; 95% confidence interval [CI], 2.1-26.5%), and 10 patients (33.3%; 95% CI, 17.3-52.8%) had stable disease after treatment. Overall, 13 patients (43.3%; 95% CI, 25.5-62.6%) achieved disease control. The median time to progression was 2.8 months (range, 0.6-12.1 months), and the median survival was 10.9 months (range, 0.8-25.3 months). Hematologic toxicity was acceptable, with grade 3 or 4 neutropenia occurring in 11% of patients and thrombocytopenia occurring in 4% of patients; no case of febrile neutropenia was observed. Nonhematologic toxicity generally was mild. CONCLUSIONS: The gemcitabine and vinorelbine combination was moderately active and had an acceptable toxicity profile in pemetrexed-pretreated patients with MPM. The role of second-line treatment in MPM needs to be evaluated in prospective trials in large series of patients who are stratified according to previous treatment and prognostic factors.
BACKGROUND. Pemetrexed-cisplatin chemotherapy is the standard of care in the
first-line treatment of unresectable malignant pleural mesothelioma (MPM). Second-
line cytotoxic therapy is considered for a growing group of patients, but the
optimal treatment has not been defined to date. Gemcitabine and vinorelbine
have shown activity in the first-line setting. The objective of this study was to
evaluate the activity and toxicity of the gemcitabine-vinorelbine combination in
pemetrexed-pretreated patients with MPM. METHODS. From January 2004 to September 2006,
CONCLUSIONS. The gemcitabine and vinorelbine combination was moderately
active and had an acceptable toxicity profile in pemetrexed-pretreated patients
with MPM. The role of second-line treatment in MPM needs to be evaluated in
prospective trials in large series of patients who are stratified according to previous
treatment and prognostic factors. Cancer 2008;112:1555–61. _ 2008 American
Cancer Society.