Vinorelbine in breast cancer.

Vinorelbine is a semi-synthetic vinca-alkaloid that has been approved in the treatment of advanced breast cancer. Two pharmaceutical forms, intravenous and oral, have been developed and the dose equivalence has been demonstrated to be between 30 mg intravenous and 80 mg oral. Efficacy is similar and tolerability is good in both forms, with more frequent nausea and vomiting with oral vinorelbine. Both induce neutropenia. Vinorelbine can be combined with anthracyclines and taxanes - the main toxicity being neutropenia. It can be used alone or in combination, particularly with capecitabine, in patients previously treated with anthracyclines and taxanes. A synergistic effect has been observed between vinorelbine and trastuzumab in patients with a hyperexpression of HER2 in their tumours.