Current regimens for use of vinorelbine in metastatic breast cancer: role and place of oral dosage form, metronome therapy, combinations with anti-HER 2 drugs

Abstract

The purpose of the treatment of metastatic breast cancer is overall survival improvement, thus the search for new effective regimes of chemotherapy with low toxicity is especially important. Therefore chemotherapy is one of the options for the treatment of metastatic breast cancer, for instance oral vinorelbine has shown consistant efficacy with a low toxicity profile. In this framework, an active and well tolerated oral CT option provides additional benefits for patients such as the possibilty of intake of the treatment at home and allows avoiding an intravenous infusion and alopecia if that is a priority for the patients. According to experts’ opinions vinorelbine is an efficient choice for first line of chemotherapy of metastatic breast cancer along with anthracyclines and taxanes. A meta-analysis of published trials concluded that longer first-line CT duration is associated with a marginally longer OS and a substantially longer PFS. In this context oral vinorelbine may be chosen as a preferable treatment since treament with oral vinorelbine can go on substantianaly longer than treatment with many other drugs. Vinorelbine yielded equal or superiour results to both paclitaxel and docetaxel, when combined with trastuzumab in the HER-2-positive ABC in the HERNATA and TRAVIOTA trials. And finally oral vinorelbine can be used in new metronomic regimens in which drugs are adminstered frequently or continuously. This kind of treatment maintains low, prolonged and pharmacologically active plama concentrations of drugs to avoid toxicity associated with traditional chemotherapy regimens, while achieveing tumor responce. Thus vinorelbine can be used as one of the options of metastatic breast cancer treatment.