Vinorelbine: a novel vinca alkaloid

Area of Science:

• Oncology
• Pharmacology
• Clinical Medicine

Background:

• Vinorelbine is a semisynthetic vinca alkaloid with enhanced in vitro antitumor activity compared to natural vinca alkaloids.
• It exhibits selective activity against mitotic microtubules, with reduced neurotoxicity due to higher concentrations required to affect axonal microtubules.
• Vinorelbine is lipophilic, rapidly distributed, highly protein-bound, and exhibits complex pharmacokinetic disposition with slow fecal and rapid urinary excretion.

Purpose of the Study:

• To review the chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and administration of vinorelbine.
• To evaluate the role of vinorelbine in the treatment of various cancers, particularly non-small-cell lung cancer (NSCLC).

Main Methods:

• Review of existing literature on vinorelbine's properties and clinical applications.
• Analysis of clinical study data regarding efficacy and safety in cancer patients.

Main Results:

• Vinorelbine demonstrates significant antitumor activity as a single agent and in combination with cisplatin for NSCLC.
• The combination of vinorelbine plus cisplatin shows superior response rates and survival compared to vindesine plus cisplatin.
• Encouraging results have also been observed in advanced breast cancer, ovarian epithelial cancer, and other malignancies.
• Myelosuppression is the dose-limiting adverse effect.

Conclusions:

• Vinorelbine is FDA-approved for first-line treatment of unresectable, advanced NSCLC, typically at 30 mg/sq m weekly.
• Further research is needed to establish its superiority over best supportive care in NSCLC patients.