Raleigh, NC (PRWEB) December 14, 2013
The anti-mitotic drug vinorelbine may be a safe and effective treatment for mesothelioma patients whose cancer progresses after first-line chemotherapy with the standard drugs. Pemetrexed (Alimta) is the primary first-line chemotherapy drug for mesothelioma patients with unresectable disease. The drug is usually paired with a platinum-based agent like cisplatin.
But there is little information in the medical literature about what to do when first-line mesothelioma treatment does not work. Vinorelbine, a drug derived from the rosy periwinkle and marketed under the brand name Navelbine, may be a safe and effective choice, according to a new study published in the journal Lung Cancer.
Fifty-nine mesothelioma patients were included in the retrospective Italian study. Their median age was 69 and all had received at least one round of pemetrexed-based chemotherapy. Patients were given 25mg/m2 of vinorelbine intravenously every three weeks for a maximum of 6 cycles. Treatment stopped when a mesothelioma tumor began growing again or when the side effects became too severe.
The best news is that almost half of the mesothelioma patients in the study (49.1%) saw either partial response or stabilized disease as a result of vinorelbine treatment. Overall survival was 6.2 months. Patients who had the best response were those who had a high ECOG performance status, a measure of cancer patients’ general well-being, and those who had experienced at least six months of progression-free survival after their first-line chemotherapy.
Just as importantly, vinorelbine was well-tolerated by most of the mesothelioma patients. Only five patients experienced grade 3 or 4 neutropenia, a sharp decline in the white blood cells called neutrophils. For most patients, the most bothersome effects of vinorelbine treatment were fatigue and constipation.
“Vinorelbine was moderately active in pemetrexed-pretreated malignant pleural mesothelioma patients with an acceptable toxicity profile,” the researchers conclude in the journal Lung Cancer. (Zucali, PA, et al, Vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma”, November 20, 2013, Lung Cancer, Epub ahead of print. http://www.ncbi.nlm.nih.gov/pubmed/24321581)
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