Open Access

ARTICLE

Vinorelbine in Non-Small Cell Lung Cancer: Real-World Data From a Single-Institution Experience

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* Section of Clinical Pharmacology and Oncology, Department of Health Science, University of Florence, Florence, Italy
† School of Human Health, University of Florence, Florence, Italy
‡ Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
§ Unit of Pneumology and Thoracic-Pulmonary Physiopathology, Careggi University Hospital, Florence, Italy
¶ Unit of Translational Oncology, Careggi University Hospital, Florence, Italy

Oncology Research 2020, 28(3), 237-248. https://doi.org/10.3727/096504019X15755437099308

Abstract

The use of vinorelbine as a single agent or in combination regimens in non-small cell lung cancer (NSCLC) is associated with satisfactory clinical activity. However, the role of vinorelbine-based chemotherapy in chemonaive locally advanced unresectable or metastatic NSCLC patients, according to real-world treatment patterns, has still not been widely explored. Eighty-one patients treated at a single institution were retrospectively analyzed. Thirty-seven received standard first-line single-agent vinorelbine, and 44 received vinorelbine plus platinum drugs, based on physician’s choice; 61.7% were older than 70 years, and 60.5% were affected by 2 comorbidities. Sixty-three patients were evaluable for objective response: 22% achieved partial response and 41% stable disease. Median progression-free survival (PFS) was 5.4 months. A benefit in PFS was observed in patients treated with combinations vs. single-agent vinorelbine (6.7 vs. 3.5 months, p=0.043). Median overall survival (OS) was 10.4 months without a statistically significant difference between treatments (12.4 vs. 7.5 months). In 55 stage IV patients, OS was positively correlated with combination regimens, M1a stage, or 2 metastatic lesions. Grade 3–4 toxicity occurred in 33% of patients, and dose reduction in 11%. A statistically significant higher incidence of toxicity was observed in patients receiving combinations, in women, in patients younger than 75 years, or patients with metastases. In this real-word analysis, we confirmed the efficacy and tolerability of vinorelbine as a single agent or combined with platinums in patients usually underrepresented in controlled clinical trials. Single-agent vinorelbine may represent a suitable option in elderly or unfit NSCLC patients and warrants investigation as a potential drug candidate for immunochemotherapy combination regimens.

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