The current and future place of vinorelbine in cancer therapy

Vinorelbine is a new semisynthetic vinca alkaloid that differs chemically from vinblastine by a substitution of the catharanthine moiety. The antitumour activity of vinorelbine against murine tumours, human malignant cell lines and human tumour xenografts in nude mice is evidence of its powerful cytostatic activity against all tumour types. Phase I and phase II studies of intravenous vinorelbine, administered weekly as a single agent or in combination chemotherapy, have been conducted since 1985. Results suggest that vinorelbine has high activity in non-small cell lung cancer (with an overall response rate of 33 to 65%), breast cancer (overall response rate of 46 to 78%) and cisplatin-resistant ovarian carcinoma (over-all response rate of 16% and 35% with single-agent and combination therapy, respectively). In Hodgkin's disease, vinorelbine as a single agent demonstrates high activity, with overall responses ranging from 34 to 90%. Recent phase II studies assessing vinorelbine administered by continuous infusion or orally show promising response rates; however, further trials are needed to validate these preliminary results.