Matti Aapro1, Jindrich Finek. 1. Multidisciplinary Institute of Oncology, Genolier, Switzerland. maapro@genolier.net
Abstract
BACKGROUND: Oral chemotherapy is one of the options for the treatment of endocrine non-responsive metastatic breast cancer. PATIENTS AND METHODS: A search of the online PubMed database was undertaken to identify clinical trials evaluating oral vinorelbine in metastatic breast cancer. All the clinically relevant data have been analysed in this article. RESULTS: A total of 31 studies including more than 1000 patients have been included into this analysis. Oral vinorelbine either as a single-agent or in combination has shown consistent efficacy results (response rates between 27% and 85% in first-line). The all-oral combination of oral vinorelbine and capecitabine has shown comparable efficacy to a taxane-based combination in a randomised phase II study. Importantly, activity has also been observed in the subset of patients previously treated with anthracyclines and taxanes. For HER2-positive patients, oral vinorelbine in combination with trastuzumab is among the most active options. Oral vinorelbine presents a manageable tolerance profile. Neutropenia is the most common adverse event and alopecia is not frequently observed. Anti-emetic prophylaxis is recommended. CONCLUSION: Taken together, these data indicate that oral vinorelbine is a highly effective and well tolerated agent which can be used in first-line and subsequent metastatic breast cancer settings. Moreover, this compound may offer the specific advantages of oral chemotherapy, as fewer and shorter hospital visits, delayed use of central venous access devices and maintained social activities.
BACKGROUND: Oral chemotherapy is one of the options for the treatment of endocrine non-responsive metastatic breast cancer. PATIENTS AND METHODS: A search of the online PubMed database was undertaken to identify clinical trials evaluating oral vinorelbine in metastatic breast cancer. All the clinically relevant data have been analysed in this article. RESULTS: A total of 31 studies including more than 1000 patients have been included into this analysis. Oral vinorelbine either as a single-agent or in combination has shown consistent efficacy results (response rates between 27% and 85% in first-line). The all-oral combination of oral vinorelbine and capecitabine has shown comparable efficacy to a taxane-based combination in a randomised phase II study. Importantly, activity has also been observed in the subset of patients previously treated with anthracyclines and taxanes. For HER2-positive patients, oral vinorelbine in combination with trastuzumab is among the most active options. Oral vinorelbine presents a manageable tolerance profile. Neutropenia is the most common adverse event and alopecia is not frequently observed. Anti-emetic prophylaxis is recommended. CONCLUSION: Taken together, these data indicate that oral vinorelbine is a highly effective and well tolerated agent which can be used in first-line and subsequent metastatic breast cancer settings. Moreover, this compound may offer the specific advantages of oral chemotherapy, as fewer and shorter hospital visits, delayed use of central venous access devices and maintained social activities.
Authors: Ø Fløtten; B H Grønberg; R Bremnes; T Amundsen; S Sundstrøm; H Rolke; K Hornslien; T Wentzel-Larsen; U Aasebø; C von Plessen Journal: Br J Cancer Date: 2012-07-03 Impact factor: 7.640
Authors: J Gavilá; S Lopez-Tarruella; C Saura; M Muñoz; M Oliveira; L De la Cruz-Merino; S Morales; I Alvarez; J A Virizuela; M Martin Journal: Clin Transl Oncol Date: 2015-12-18 Impact factor: 3.405
Authors: Barbara A Conley; Lou Staudt; Naoko Takebe; David A Wheeler; Linghua Wang; Maria F Cardenas; Viktoriya Korchina; Jean Claude Zenklusen; Lisa M McShane; James V Tricoli; Paul M Williams; Irina Lubensky; Geraldine O'Sullivan-Coyne; Elise Kohn; Richard F Little; Jeffrey White; Shakun Malik; Lyndsay N Harris; Bhupinder Mann; Carol Weil; Roy Tarnuzzer; Chris Karlovich; Brian Rodgers; Lalitha Shankar; Paula M Jacobs; Tracy Nolan; Sean M Berryman; Julie Gastier-Foster; Jay Bowen; Kristen Leraas; Hui Shen; Peter W Laird; Manel Esteller; Vincent Miller; Adrienne Johnson; Elijah F Edmondson; Thomas J Giordano; Benjamin Kim; S Percy Ivy Journal: J Natl Cancer Inst Date: 2021-01-04 Impact factor: 11.816