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

  • 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
Research Article

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.

Keywords

Non-small cell lung cancer Metronomic Oral vinorelbine Elderly Unfit patients 

Notes

Acknowledgements

This study was funded by an unrestricted grant from Lega Italiana per la Lotta contro i Tumori (L.I.L.T.) Sezione Provinciale Lucchese to AC. The authors are grateful to Miss Lara Camerini for editorial assistance and language revision.

Funding

This study was funded by an unrestricted grant from Lega Italiana per la Lotta contro i Tumori (L.I.L.T.) Sezione Provinciale Lucchese to AC.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  • A. Camerini
    • 1
  • G. L. Banna
    • 2
  • S. Cinieri
    • 3
  • A. Pezzuto
    • 4
  • M. Mencoboni
    • 5
  • F. Rosetti
    • 6
  • A. Figueiredo
    • 7
  • P. Rizzo
    • 3
  • A. Ricci
    • 8
  • L. Langenhoven
    • 9
  • A. Santo
    • 10
  • A. Addeo
    • 11
  • D. Amoroso
    • 1
  • F. Barata
    • 7
  1. 1.Medical OncologyVersilia Hospital – ASL Toscana Nord-OvestLido di CamaioreItaly
  2. 2.Division of Medical OncologyCannizzaro HospitalCataniaItaly
  3. 3.Medical OncologyPerrino HospitalBrindisiItaly
  4. 4.Department of Cardio-Thoracic-Vascular ScienceS. Andrea HospitalRomeItaly
  5. 5.Medical OncologyASL 3 Genovese, Ospedale Villa ScassiGenoaItaly
  6. 6.Medical OncologyULSS3 Serenissima, Distretto Mirano-DoloDoloItaly
  7. 7.PneumologyCentro Hospitalar e Universitario de CoimbraCelas-CoimbraPortugal
  8. 8.Department of Molecular and Clinical MedicineS. Andrea HospitalRomeItaly
  9. 9.Clinical OncologyPanorama Oncology CentreCape TownSouth Africa
  10. 10.Medical OncologyUniversity Hospital of VeronaVeronaItaly
  11. 11.Oncology DepartmentUniversity Hospital GenevaGenevaSwitzerland

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