BACKGROUND: Elderly patients with metastatic breast cancer (MBC) have more problems receiving chemotherapy than younger patients, especially with the presence of multiple comorbidities, adverse drug events and functional decline. Low-dose oral administration of cytotoxic agents such as vinorelbine, a semisynthetic vinca alkaloid that interferes with microtubule assembly, leading to arrest of cell division, is usually effective and well tolerated. METHODS: From February 2010 to February 2014, 32 patients with MBC, median age 76 years (range 69-83) were treated with oral vinorelbine 30 mg (total dose), one day on and one day off, until disease progression or unacceptable toxicity levels were reported. Toxicity, quality of life and clinical benefit were evaluated. Matched t-tests were conducted to discern whether quality-of-life indicator (p<0.05 was considered significant) differed before and 6 months after treatment. Statistical analysis was performed using Graph Pad Prism 5.0 (GraphPad Software Inc., San Diego, CA, USA). RESULTS: No grade 3 and 4 adverse events were reported. A clinical benefit of 50% was found in our cohort. On and off metronomic vinorelbine oral administration resulted in good tolerability and safe profile in our selected elderly population, and improved patient adherence to therapy. CONCLUSIONS: The present study demonstrated that metronomic vinorelbine might be a potential treatment in elderly patients by reducing adverse effects and increasing quality of life, setting the stage for future extensive clinical trials.
BACKGROUND: Elderly patients with metastatic breast cancer (MBC) have more problems receiving chemotherapy than younger patients, especially with the presence of multiple comorbidities, adverse drug events and functional decline. Low-dose oral administration of cytotoxic agents such as vinorelbine, a semisynthetic vinca alkaloid that interferes with microtubule assembly, leading to arrest of cell division, is usually effective and well tolerated. METHODS: From February 2010 to February 2014, 32 patients with MBC, median age 76 years (range 69-83) were treated with oral vinorelbine 30 mg (total dose), one day on and one day off, until disease progression or unacceptable toxicity levels were reported. Toxicity, quality of life and clinical benefit were evaluated. Matched t-tests were conducted to discern whether quality-of-life indicator (p<0.05 was considered significant) differed before and 6 months after treatment. Statistical analysis was performed using Graph Pad Prism 5.0 (GraphPad Software Inc., San Diego, CA, USA). RESULTS: No grade 3 and 4 adverse events were reported. A clinical benefit of 50% was found in our cohort. On and off metronomic vinorelbine oral administration resulted in good tolerability and safe profile in our selected elderly population, and improved patient adherence to therapy. CONCLUSIONS: The present study demonstrated that metronomic vinorelbine might be a potential treatment in elderly patients by reducing adverse effects and increasing quality of life, setting the stage for future extensive clinical trials.
Authors: Christoph Thomssen; Diana Lüftner; Michael Untch; Renate Haidinger; Rachel Würstlein; Nadia Harbeck; Doris Augustin; Susanne Briest; Johannes Ettl; Peter A Fasching; Frank Förster; Christian M Kurbacher; Hans-Joachim Lück; Norbert Marschner; Lothar Müller; Volkmar Müller; Lidia Perlova-Griff; Isabel Radke; Eugen Ruckhäberle; Iris Scheffen; Eva Schumacher-Wulf; Moritz Schwoerer; Dieter Steinfeld-Birg; Katja Ziegler-Löhr Journal: Breast Care (Basel) Date: 2020-02-10 Impact factor: 2.860
Authors: Slavomir Krajnak; Thomas Decker; Lukas Schollenberger; Christian Rosé; Christian Ruckes; Tanja Fehm; Christoph Thomssen; Nadia Harbeck; Marcus Schmidt Journal: J Cancer Res Clin Oncol Date: 2021-03-20 Impact factor: 4.553
Authors: M E Cazzaniga; L Cortesi; A Ferzi; L Scaltriti; F Cicchiello; M Ciccarese; S Della Torre; F Villa; M Giordano; C Verusio; M Nicolini; A R Gambaro; L Zanlorenzi; E Biraghi; L Legramandi; E Rulli Journal: Breast Cancer Res Treat Date: 2016-10-17 Impact factor: 4.872