Use of vinflunine in urothelial bladder carcinoma

Abstract

Background Vinflunine is a vinca alkaloid indicated as monotherapy for the treatment of patients with advanced or metastatic carcinoma transitional cell urothelial tract after failure of prior treatment that included platinum compounds. Purpose To analyse the use of vinflunine in a 600-bed hospital. Materials and methods Retrospective study of patients treated with vinflunine from February 2010 to April 2011. Data were collected from Oncofarm ® software, medical records of patients and dispensing program to outpatients. Results The authors studied 6 patients: 5 men and 1 woman, mean age: 67 (52-80) years. 4 had distant metastases (M1) at diagnosis and 2 showed no metastasis (M0). As first lines: 2 patients received carboplatin-gemcitabine scheme, with an average of 7 cycles; 2 received carboplatin-gemcitabine with an average of 7 cycles; 1 received 2 cycles of carboplatin-gemcitabine, followed by 4 cycles Gemcitabine; 1 received 5 cycles of cisplatin-gemcitabine, followed by 2 cycles of carboplatin-gemcitabine and 3 cycles of gemcitabine alone. As a second line: 3 patients received Vinflunine an average of 4 cycles; 2 received paclitaxel with an average of 4 cycles, and 1 received 8 cycles of cisplatin-gemcitabine. As a third-line: 2 patients received Vinflunine with an average of 5 cycles and 1 received 3 cycles of paclitaxel, following by a 4th line with 1 cycle of vinflunine. The use of vinflunine regimen in 2 patients was due to progression of liver carcinoma, in 2 to cerebral progression, in 1 to lung and bone progression, and progression in 1 to lung, liver and pelvic node. No patient received other subsequent treatment lines, 3 died of disease progression, 1 is currently being treated with vinflunine and 2 with symptomatic treatment. Conclusions Vinflunine was used in all cases correctly according to its indication, and may be an alternative for patients with advanced transitional cell urothelial tract carcinoma.