Treatment of non-small cell lung cancer: new cytostatic agents

Sørensen, Jens Benn

doi:10.1016/0169-5002(93)90178-z

Cited by 11 publications

(2 citation statements)

References 34 publications

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“…[88,156,157] As demonstrated in noncomparative and several comparative trials, the combination of vinorelbine plus cisplatin further improves response rates, to 30 to 50%, and in the largest trial (in >600 participants) increased survival compared with vinorelbine alone. Response rates of about 15 to 30% and median survival duration of 25 to 33 weeks obtained in noncomparative and comparative trials place vinorelbine alongside other drugs, such as cisplatin, ifosfamide/mesna, mitomycin, vinblastine, vindesine and etoposide, historically having single agent efficacy in NSCLC.…”

Section: Place Of Vinorelbine In Cancer Chemotherapymentioning

confidence: 98%

Vinorelbine

Goa¹,

Faulds²

1994

Drugs & Aging

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Vinorelbine is a semisynthetic vinca alkaloid with a broad spectrum of antitumour activity. The drug is effective as a single agent in inoperable/advanced non-small cell lung cancer (NSCLC), producing objective response rates of about 15 to 30%, and as first-line or later chemotherapy for metastatic spread in advanced breast cancer. Combining vinorelbine with standard chemotherapeutic regimens improves response rates in these indications compared with vinorelbine monotherapy: in NSCLC response rates increase to 30 to 50% when vinorelbine is administered with cisplatin. Importantly, survival was prolonged by a further 9 weeks with this combination in a trial in > 600 patients with NSCLC. Comparative trials evaluating vinorelbine in women with advanced breast cancer are few at present. However, results suggest greater efficacy for vinorelbine than for melphalan as second-line chemotherapy, and similar efficacy for vinorelbine plus doxorubicin compared with doxorubicin plus 2 other drugs as first-line chemotherapy. Vinorelbine has tended to yield superior response rates when compared with vindesine, and appears to have greater haematological toxicity (i.e. granulocytopenia) but less neurological toxicity (peripheral neuropathy, constipation, loss of deep tendon reflexes) than this agent. Myelosuppression is the most frequent cause of vinorelbine treatment delay or dose reduction. Other consequences of vinorelbine therapy are those typically seen with antineoplastic agents, such as diarrhoea, nausea and vomiting, and alopecia. However, these are rarely severe. Early clinical investigations indicate that the antitumour effects of vinorelbine in other malignancies including ovarian carcinoma, lymphoma and head and neck cancer warrant further exploration, as does the efficacy of the drug relative to standard approaches and its possible beneficial effects on quality of life of cancer patients. Clarification is also required of the feasibility of an oral dosage form, which in preliminary investigations has shown some efficacy in NSCLC, but a variable response rate and high incidence of gastrointestinal disturbances in women with breast cancer. Thus, vinorelbine as a single agent or combined palliative therapy is effective against advanced NSCLC, and as first- or second-line chemotherapy in advanced breast cancer. This semisynthetic vinca alkaloid has a manageable tolerability profile and potential for use in other malignancies and as an oral formulation. With these attributes, vinorelbine is a valuable option which extends the range of treatments available for these difficult-to-treat malignancies.

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Section: Place Of Vinorelbine In Cancer Chemotherapymentioning

confidence: 98%

Vinorelbine

Goa¹,

Faulds²

1994

Drugs & Aging

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“…The largest experience has been in non-small-cell lung cancer and breast cancer, but activity, first noted in phase I trials, has been observed in ovarian and cervical cancer. 38,58,59 Subsequent studies have evaluated activity as a single agent, with responses observed in 15% to 30% of patients with non-small-cell lung cancer, [60][61][62] making vinorelbine one of the more active agents in this disease. The combination of vinorelbine and cisplatin further improves response rates from 30% to 50% and, in the largest trial by Le Chevalier et al, increased survival compared with vinorelbine alone.…”

Section: Clinical Activitymentioning

confidence: 99%

20th‐Century Advances in Drug Therapy in Oncology—Part II

Dutcher

Novik

Marcoullis

et al. 2000

The Journal of Clinical Pharma

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Ongoing research in cancer therapy has led to the development of antineoplastic agents which target specific components of the cell cycle. In Part II of this series, we discuss agents which target the mitotic mechanism by inhibiting microtubules. Although many of these agents are being shown to have multiple effects, the Vinca alkaloids and the taxanes are known as antimitotic drugs. They are among the most important anticancer agents currently available, and because of their unique mechanisms, can be combined with a wide variety of other antineoplastic agents in a spectrum of diseases. In addition, in part II, we are discussing agents that target DNA and prevent replication and thus cell growth by inhibiting the enzymes which protect DNA during replication, the topoisomerases. These drugs, too, have unique mechanisms of action and have become major components of combination regimens. The topoisomerase I inhibitors are new drugs derived from an older parent drug, and their full possibilities are still being explored.

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