Lung Cancer: Lung Cancer I |

Oral Vinorelbine Monotherapy as a Second Line Chemotherapy Agent in Patients With Squamous Cell Carcinoma (SCC) FREE TO VIEW

Ioannis Dimitroulis, PhD; Ioanna Avgerinou, MD; Adamantia Liapikou, PhD; Michail Toumbis, PhD
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“Sotiria” Hospital for Thoracic Diseases, Athens, Greece

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):695A. doi:10.1016/j.chest.2016.08.790
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Metronomic chemotherapy is considered an anti-angiogenic therapy that involves chronic administration of low-dose chemotherapy at regular short intervals (Briasoulis et al., 2009) We investigated the optimal metronomic dose of oral vinorelbine (out of two regimens), when given as second line monotherapy in patients (pts) with metastatic SCC.

METHODS: Patients with metastatic stage IV squamous cell carcinoma (ECOG 0-2) were randomly assigned to 40 or 50 mg vinorelbine, taken orally three times a week (every other day but weekends). Treatment continued until disease progression or unacceptable toxicity. Endpoints were response rate (RR), progression-free survival at 6 months (PFS defined as the percentage of pts that were progression free at 6 months), and toxicity. Secondary endpoint was overall survival (OS) at 12 months.

RESULTS: Twenty eight patients were enrolled. Fifteen patients were enrolled in the 40mg group vs thirteen pts in the 50mg group. RR was 63% in the 40mg group vs 73% in the 50mg vinorelbine group. PFS at 6 months was 73% in the 40mg group vs 78% in the 50mg vinorelbine group. Toxicity was 18% in the 40mg group vs 24% in the 50mg vinorelbine group and involved mainly hematological toxicity (leucopenia up to grade 3 and anemia up to grade 2). OS at 12 months was 48% for the 40mg group vs 56% for the 50mg vinorelbine group.

CONCLUSIONS: Oral vinorelbine administered in the metronomic schedule is a well tolerated second line monotherapy in patients with metastatic SCC. Considering the relatively low toxicity rate in both groups, we recommend the administration of 50mg oral vinorelbine three times a week as it has better response, progression free survival and overall survival rates in SCC pts with ECOG 0-2.

CLINICAL IMPLICATIONS: Since oral vinorelbine on a metronomic schedule can be administered on an outpatient basis, it is a considerable second line treatment option for patients who do not have access to a hospital or clinic, or who are reluctang in following an iv regimen of chemotherapy. It is well tolerated and has considerable efficacy.

DISCLOSURE: The following authors have nothing to disclose: Ioannis Dimitroulis, Ioanna Avgerinou, Adamantia Liapikou, Michail Toumbis

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