Efficacy and Safety of Vinorelbine-Capecitabine Oral Metronomic Combination in Elderly Metastatic Breast Cancer Patients: VICTOR-1 Study

Cazzaniga, M.; Torri, Valter; Riva, Francesca; Porcu, Luca; Cicchiello, Federica; Capici, Serena; Digiacomo, Nunzio; Bidoli, Paolo

doi:10.5301/tj.5000543

Cited by 18 publications

(12 citation statements)

References 9 publications

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“…A meta‐analysis [26] including all metronomic regimens for advanced breast cancer and prostate cancer showed that the mean ORR of mCHT was 26.0% and the median PFS was 4.6 months. Studies of other metronomic regimens with or without targeted therapy have reported the ORR of 18%‐62% and PFS ranging from 4.3 to 10.8 months [16, 17, 27‐29]. No clinical trials have compared the efficacy among these regimens.…”

Section: Discussionmentioning

confidence: 99%

“…Since many trials in metastatic setting have shown mCHT as a well‐tolerated treatment strategy, the expert panel in the “Metronomic chemotherapy for advanced breast cancer” study group agreed that mCHT can be a treatment option for metastatic disease in selected patients [6]. Vinorelbine, capecitabine, CTX, and MTX are most commonly used agents in clinical practice, and their metronomic dosages have been assessed in several studies [16‐19]. Further, it is easy to modify their dosages when adverse events occur.…”

Section: Introductionmentioning

confidence: 99%

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Metronomic chemotherapy of cyclophosphamide plus methotrexate for advanced breast cancer: Real‐world data analyses and experience of one center

Lee

et al. 2020

Cancer Communications

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metronomic chemotherapy of cyclophosphamide plus methotrexate for advanced breast cancer: Real‐world data analyses and experience of one center

Lee

et al. 2020

Cancer Communications

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“…(3) Elderly patients: These patients may represent the strongest indication for MCT, with the mild toxicity profile, QOL benefits, and convenience/acceptability of oral MCT regimens offering particular advantages in elderly individuals. This is supported by several positive studies of vinorelbine-based MCT in older patients with advanced breast cancer [22,25,26].…”

Section: Patient Selection For Mctmentioning

confidence: 63%

“…Efficacy data were promising, with a CBR of 58.1% (n = 18/31). In a sub-analysis of 18 elderly subjects (aged ≥ 70 years) in VICTOR-1, the CBR was even higher (67%), albeit in a small group of patients [26]. VICTOR-2 was a larger, multicenter, Phase 2 study based on the recommended doses of oral vinorelbine and capecitabine established in VICTOR-1 [25].…”

Section: Article Highlightsmentioning

confidence: 99%

Metronomic therapy in advanced breast cancer and NSCLC: vinorelbine as a paradigm of recent progress

Sun

Wang

et al. 2020

Expert Review of Anticancer Therapy

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Introduction: Metronomic chemotherapy (MCT) is based on frequent dosing of the drug.. This leads to pharmacologically active but low plasma concentrations that reduce toxicity. MCT seems to work primarily via indirect effects on tumor cells and their microenvironment, rather than direct antitumor effects. Oral vinorelbine is one of the most widely studied MCT approaches in both advanced breast cancer and non-small cell lung cancer. Expert opinion: MCT with vinorelbine has proven efficacy, tolerability and quality of life benefits both as monotherapy and in combination with other MCTs or targeted agents, in first-line therapy and in previously treated patients. Key populations are emerging who may be particularly well suited to metronomic vinorelbine, including those with indolent disease, older individuals, and those with multiple comorbidities and/or bone metastases. Ongoing trials should help to further delineate these target groups. Additional work is needed to better understand the optimal vinorelbine regimen, particularly when used in combination or in non-Caucasian patients. Markers are also required to help identify individuals who are most likely to respond. Nonetheless, the efficacy and tolerability of MCT, allied to improved patient convenience, reduced need for medical engagement and lower cost, make it an appealing option-particular in resource-constrained healthcare environments.

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“…Similar findings have been reported in other studies. In a sub-analysis of 18 elderly patients enrolled in the VICTOR-1 study, median time to progression (TTP) was 10.5 months (range 1–40 months), with an objective response rate (ORR) of 33% and a clinical benefit rate of 67% 32. In the VICTOR-2 study, median TTP was 6.5 months in 28 patients with triple-negative breast cancer and 8.3 months in those with HR+ disease (n=52) 33.…”

Section: Statements and Supporting Evidencementioning

confidence: 99%

<p>Treating advanced breast cancer with metronomic chemotherapy: what is known, what is new and what is the future?</p>

Cazzaniga¹,

Biganzoli²,

Cortesi³

et al. 2019

OTT

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The prognosis for patients with locally advanced or metastatic breast cancer (mBC) remains poor, with a median survival of 2–4 years. About 10% of newly diagnosed breast cancer patients present with metastatic disease, and 30%–50% of those diagnosed at earlier stages will subsequently progress to mBC. In terms of ongoing management for advanced/metastatic breast cancer after failure of hormonal therapy, there is a high medical need for new treatment options that prolong the interval to the start of intensive cytotoxic therapy, which is often associated with potentially serious side effects and reduced quality of life. Oral chemotherapeutic agents such as capecitabine and vinorelbine have demonstrated efficacy in patients with mBC, with prolonged disease control and good tolerability. Use of oral chemotherapy reduces the time and cost associated with treatment and is often more acceptable to patients than intravenous drug delivery. Metronomic administration of oral chemotherapy is therefore a promising treatment strategy for some patients with mBC and inhibits tumor progression via multiple mechanisms of action. Ongoing clinical trials are investigating metronomic chemotherapy regimens as a strategy to prolong disease control with favorable tolerability. This article provides an overview of metronomic chemotherapy treatment options in mBC, with perspectives on this therapy from a panel of experts.

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Efficacy and Safety of Vinorelbine-Capecitabine Oral Metronomic Combination in Elderly Metastatic Breast Cancer Patients: VICTOR-1 Study

Abstract: The all-oral metronomic combination of vinorelbine and capecitabine had an acceptable efficacy profile and appears to be better tolerated than standard treatment schedules in elderly metastatic breast cancer patients (age ≥70 years).

Cited by 18 publications

References 9 publications

Metronomic chemotherapy of cyclophosphamide plus methotrexate for advanced breast cancer: Real‐world data analyses and experience of one center

Metronomic chemotherapy of cyclophosphamide plus methotrexate for advanced breast cancer: Real‐world data analyses and experience of one center

Metronomic therapy in advanced breast cancer and NSCLC: vinorelbine as a paradigm of recent progress

<p>Treating advanced breast cancer with metronomic chemotherapy: what is known, what is new and what is the future?</p>

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