Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis

Camerini, Andrea; Banna, Giuseppe Luigi; Cinieri, Saverio; Pezzuto, Aldo; Mencoboni, Manlio; Rosetti, Francesco; Figueiredo, Ana; Rizzo, P.; Rícci, Alberto; Langenhoven, Lizanne; Santo, Antonio; Addeo, Alfredo; Amoroso, Domenico; Barata, Fernando

doi:10.1007/s12094-018-1989-y

Cited by 26 publications

(24 citation statements)

References 24 publications

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“…Metronomic oral vinorelbine is an extremely safe treatment for advanced NSCLC with notable clinical benefit, mainly consisting of long-term disease stabilization (15). Camerini et al (16) reported that the median survival of 14 patients with NSCLC who underwent MCT was >30 months.…”

Section: Clinical Trials Of Mctmentioning

confidence: 99%

Metronomic chemotherapy in non‑small cell lung cancer (Review)

2020

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Metronomic chemotherapy (MCT) is defined as the rhythmic chemotherapy of low-dose cytotoxic drugs with short or no drug-free breaks over prolonged periods. MCT affects tumor cells and the tumor microenvironment. Particularly, the low-dose schedule impairs the repair process of endothelial cells, resulting in an anti-angiogenesis effect. By stimulating the immune system to eliminate tumor cells, MCT induces immunological activation. Furthermore, combined with targeted therapy, anti-angiogenic drugs enhance the efficacy of MCT. The present review is an overview of phase I, II and III clinical trials focusing on the efficacy, toxicity and mechanism of MCT in patients with non-small cell lung cancer (NSCLC). Furthermore, the prospects of MCT in NSCLC have been discussed. The present review indicated that MCT is an efficacious treatment for selected patients with NSCLC, with acceptable systemic side effects and economic viability for public health. Contents 1. Introduction 2. Preclinical studies of MCT 3. Clinical trials of MCT 4. Mechanism of MCT 5. Conclusion

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Section: Clinical Trials Of Mctmentioning

confidence: 99%

Metronomic chemotherapy in non‑small cell lung cancer (Review)

2020

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“…Lung cancer, one of the most common cancers with high degree of malignancy, is a devastating disease with a poor prognosis worldwide 1–4. Approximately 85% of the lung cancers are diagnosed as non-small-cell lung cancer (NSCLC), which composed of 2 major histology subtypes: squamous (SQ) and non-squamous (non-SQ) carcinoma.…”

Section: Introductionmentioning

confidence: 99%

<p>Neutrophil–lymphocyte ratio (NLR) predicted prognosis for advanced non-small-cell lung cancer (NSCLC) patients who received immune checkpoint blockade (ICB)</p>

Ren

Zhao

Liu³

et al. 2019

OTT

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Purpose: The aim of this study was to identify the prognostic value of blood neutrophil–lymphocyte ratio (NLR) in patients with advanced non-small-cell lung cancer (NSCLC) who received immune checkpoint blockade (ICB) therapy. Materials and methods: 147 advanced NSCLC patients were enrolled in this study from June 30, 2013, to August 30, 2017. Survival analysis used the Kaplan and Meier methodology. The mean follow-up time was 2.6 years. The phenotypic T cells subtypes were evaluated by flow cytometry. Results: Of these patients, receiver operating characteristic (ROC) curves analysis were used to confirm the cut-off value, and patients were stratified into NLR>2.5 (n=88) and NLR≤2.5 (n=59) groups. Survival analysis showed that patients with NLR≤2.5 had significantly favorable overall survival (OS) and progression-free survival (PFS) compared with patients with NLR>2.5. After stratified with the tumor mutational burden (TMB), we further found that patients with NLR≤2.5 had significantly favorable OS and PFS compared with patients with NLR>2.5 in the group of patients with TMB>10, while in group patients with TMB≤10, patients with NLR≤2.5 had no significantly favorable OS and PFS compared with patients with NLR>2.5. The CD3 + and CD8 + /CD28 + T cell subsets were significantly increased in patients with NLR≤2.5 ( P <0.05), while the CD8 + /CD28 − and CD4 + /CD25 + cell subsets were significantly decreased in patients with NLR≤2.5 ( P <0.05). Conclusion: High NLR value independently predicted poorer survival in advanced NSCLC patients received ICB therapy. The NLR may help oncologists to predict outcomes of patients received ICB and choose alternative therapies for patients with high NLR value.

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“…Recent retrospective data on the use of metronomic vinorelbine in the 'real world' setting have largely been consistent with prospective trials [14,38]. For example, an analysis of 270 largely elderly patients with advanced NSCLC and a median of three serious comorbidities, confirmed that treatment with metronomic vinorelbine -mostly in the first line (67% of patients) -is associated with considerable clinical activity [38].…”

Section: Metronomic Oral Vinorelbine In Advanced Nsclcmentioning

confidence: 76%

“…The efficacy of metronomic oral vinorelbine monotherapy in the treatment of advanced NSCLC has been assessed in many studies [14,[31][32][33][34][35][36][37][38][39]. Most were conducted in patients who were elderly and/or frail, with typical CBR or disease control rates (DCR) of 50-60%.…”

Section: Metronomic Oral Vinorelbine In Advanced Nsclcmentioning

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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Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis

Cited by 26 publications

References 24 publications

Metronomic chemotherapy in non‑small cell lung cancer (Review)

Metronomic chemotherapy in non‑small cell lung cancer (Review)

<p>Neutrophil–lymphocyte ratio (NLR) predicted prognosis for advanced non-small-cell lung cancer (NSCLC) patients who received immune checkpoint blockade (ICB)</p>

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

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