Metronomic Chemotherapy with Vinorelbine Produces Clinical Benefit and Low Toxicity in Frail Elderly Patients Affected by Advanced Non-Small Cell Lung Cancer

• Published in: BioMed research international Vol. 2018; no. 2018; pp. 1 - 6
• Main Authors: Ricci, Alberto, Grieco, Alessio, Bruno, Pierdonato, Sposato, Bruno, Fiorentino, Chiara, Pezzuto, Aldo, D’Ascanio, Michela, Mancini, Rita
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01-01-2018; Hindawi; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Administration, Metronomic; Age; Aged; Aged patients; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomedical research; Cancer; Cancer therapies; Carcinoma, Non-Small-Cell Lung - drug therapy; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Chemotherapy; Clinics; Comorbidity; Disease control; Drug dosages; Female; Frail Elderly; Geriatrics; Humans; Liver diseases; Lung cancer; Lung cancer, Non-small cell; Lung cancer, Small cell; Lung Neoplasms - drug therapy; Male; Metabolism; Neoplasm Staging; Non-small cell lung carcinoma; Older people; Oncology; Patient compliance; Patients; Retrospective Studies; Schedules; Survival; Toxicity; Treatment Outcome; Vinblastine - administration & dosage; Vinorelbine; Vinorelbine - administration & dosage
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2018/6278403

Background. Lung cancer is the leading cause of death worldwide. The treatment choice for advanced stage of lung cancer may depend on histotype, performance status (PS), age, and comorbidities. In the present study, we focused on the effect of metronomic vinorelbine treatment in elderly patients with advanced unresectable non-small cell lung cancer (NSCLC). Methods. From January 2016 to December 2016, 44 patients affected by non-small cell lung cancer referred to our oncology day hospital were progressively analyzed. The patients were treated with oral vinorelbine 30 mg x 3/wk or 40 mg x 3/wk meaning one day on and one day off. The patients were older than 60, stage IIIB or IV, ECOG PS ≥ 1, and have at least one important comorbidity (renal, hepatic, or cardiovascular disease). The schedule was based on ECOG-PS and comorbidities. The primary endpoint was progression-free survival (PFS). PFS was used to compare patients based on different scheduled dosage (30 or 40 mg x3/weekly) and age (more or less than 75 years old) as exploratory analysis. We also evaluated as secondary endpoint toxicity according to Common Toxicity Criteria Version 2.0. Results. Vinorelbine showed a good safety profile at different doses taken orally and was effective in controlling cancer progression. The median overall survival (OS) was 12 months. The disease control rate (DCR) achieved 63%. The median PFS was 9 months. A significant difference in PFS was detected comparing patients aged below with those over 75, and the HR value was 0.72 (p<0.05). Not significant was the difference between groups with different schedules. Conclusions. This study confirmed the safety profile of metronomic vinorelbine and its applicability for patients unfit for standard chemotherapies and adds the possibility of considering this type of schedule not only for very elderly patients.