Vinorelbine. A review of its antitumour activity in lung cancer

Vinorelbine is a new semisynthetic vinca alkaloid. Data from in vitro and in vivo preclinical studies suggest that vinorelbine is active in both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). There are at present no clinical data on the activity of vinorelbine in patients with SCLC. The response rate with single-agent vinorelbine in patients with NSCLC was 30% overall in two phase II studies including a total of 153 patients; all responses were partial. Response rates of 14 and 33%, respectively were observed in 2 randomised studies, with 1 response of 41 being complete. Vinorelbine is among the most active single drugs in the treatment of NSCLC, but comparative studies with other vinca alkaloids are lacking. Combinations of vinorelbine with cisplatin have shown response rates of 28 to 33% in 2 studies. The drug is well-tolerated in patients with NSCLC. Leucopenia is a dose-limiting factor, while peripheral neurotoxicity does not appear to be a problem.