Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis

• A. Camerini ^[2] ; G. L. Banna ^[3] ; S. Cinieri ^[4] ; A. Pezzuto ^[5] ; M. Mencoboni ^[6] ; F. Rosetti ^[7] ; A. Figueiredo ^[8] ; P. Rizzo ^[4] ; A. Ricci ^[9] ; L. Langenhoven ^[1] ; A. Santo ^[10] ; A. Addeo ^[11] ; D. Amoroso ^[2] ; F. Barata ^[8]
  1. [1] University of Cape Town

     University of Cape Town

     City of Cape Town, Sudáfrica

     
  2. [2] Medical Oncology, Versilia Hospital. Lido di Camaiore, Italy
  3. [3] Division of Medical Oncology, Cannizzaro Hospital. Catania, Italy
  4. [4] Medical Oncology, Perrino Hospital. Brindisi, Italy
  5. [5] Department of Cardio-Thoracic-Vascular Science, S. Andrea Hospital. Rome, Italy
  6. [6] Medical Oncology, Ospedale Villa Scassi. Genoa, Italy
  7. [7] Medical Oncology, ULSS3 Serenissima. Distretto Mirano-Dolo, Italy
  8. [8] Pneumology, Centro Hospitalar e Universitario de Coimbra. Portugal
  9. [9] Department of Molecular and Clinical Medicine, S. Andrea Hospital. Rome, Italy
  10. [10] Medical Oncology, University Hospital of Verona. Italy
  11. [11] Oncology Department, University Hospital Geneva. Switzerland

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 21, Nº. 6, 2019, págs. 790-795
• Idioma: inglés
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• Resumen

  • 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.