Background: The survival rate of patients with lung cancer has increased significantly over the years, but there has been no further progress in third- or fourth-line therapy. We investigated the efficacy and tolerability of monotherapy with weekly vinorelbine, a semi-synthetic vinca alkaloid, in advanced non-small-cell lung cancer (NSCLC) patients who had previously been treated several times. Methods: In all, 159 NSCLC patients who received vinorelbine monotherapy as third- or further-line therapy between January 2008 and July 2017 were included in this study. Patients received vinorelbine intravenously at a dose of 25–30 mg/m2/week. Results: Their mean age was 62.4 years. The histologic types of tumor were adenocarcinoma (50.9%), squamous cell carcinoma (42.8%), and others (6.2%). The overall response rate was 19.5% (31/159). The median progression-free survival (PFS) was 3.0 months (95% confidence interval [CI] 2.5–3.5 months), and the median overall survival (OS) after vinorelbine use was 7.6 months (95% CI 6.2–9.0 months). Vinorelbine therapy showed significantly higher efficacy in patients with adenocarcinoma, and these patients had a longer PFS than patients with other types of cancer. Patients who received vinorelbine as fifth- or further-line treatment had a higher response rate and longer PFS and OS than those who received vinorelbine as third- or fourth-line treatment. Conclusions: Weekly vinorelbine monotherapy may be a feasible therapeutic option for patients with heavily treated, advanced NSCLC, particularly lung adenocarcinoma.

1.
Ramalingam
S
,
Belani
C
.
Systemic chemotherapy for advanced non-small cell lung cancer: recent advances and future directions
.
Oncologist
.
2008
;
13
Suppl 1
:
5
13
.
[PubMed]
1083-7159
2.
Eberhardt
WE
,
Mitchell
A
,
Crowley
J
,
Kondo
H
,
Kim
YT
,
Turrisi
A
 3rd
, et al
The IASLC lung cancer staging project: proposals for the revision of the M descriptors in the forthcoming
eighth edition of the TNM classification of lung cancer. Journal of thoracic oncology
2015
;10:1515-1522.
3.
Murillo
JR
 Jr
,
Koeller
J
.
Chemotherapy given near the end of life by community oncologists for advanced non-small cell lung cancer
.
Oncologist
.
2006
Nov-Dec
;
11
(
10
):
1095
9
.
[PubMed]
1083-7159
4.
Masters
GA
,
Johnson
DH
,
Temin
S
.
Systemic therapy for stage IV non–small-cell lung cancer: american Society of Clinical Oncology clinical practice guideline update
.
J Oncol Pract
.
2016
Jan
;
12
(
1
):
90
3
.
[PubMed]
1554-7477
5.
Temel
JS
,
Greer
JA
,
Muzikansky
A
,
Gallagher
ER
,
Admane
S
,
Jackson
VA
, et al
Early palliative care for patients with metastatic non-small-cell lung cancer
.
N Engl J Med
.
2010
Aug
;
363
(
8
):
733
42
.
[PubMed]
0028-4793
6.
Lee
YJ
,
Yang
JH
,
Lee
JW
,
Yoon
J
,
Nah
JR
,
Choi
WS
, et al
Association between the duration of palliative care service and survival in terminal cancer patients
.
Support Care Cancer
.
2015
Apr
;
23
(
4
):
1057
62
.
[PubMed]
0941-4355
7.
Shanafelt
TD
,
Loprinzi
C
,
Marks
R
,
Novotny
P
,
Sloan
J
.
Are chemotherapy response rates related to treatment-induced survival prolongations in patients with advanced cancer?
J Clin Oncol
.
2004
May
;
22
(
10
):
1966
74
.
[PubMed]
0732-183X
8.
Asahina
H
,
Sekine
I
,
Horinouchi
H
,
Nokihara
H
,
Yamamoto
N
,
Kubota
K
, et al
Retrospective analysis of third-line and fourth-line chemotherapy for advanced non-small-cell lung cancer
.
Clin Lung Cancer
.
2012
Jan
;
13
(
1
):
39
43
.
[PubMed]
1525-7304
9.
Roeland
E
,
Loprinzi
C
,
Moynihan
TJ
,
Smith
TJ
,
Temel
J
.
In chemotherapy for lung cancer, sometimes less is more
.
J Natl Compr Canc Netw
.
2013
Mar
;
11
(
3
):
232
5
.
[PubMed]
1540-1405
10.
Syrigos
KN
,
Saif
MW
,
Karapanagiotou
EM
,
Oikonomopoulos
G
,
De Marinis
F
.
The need for third-line treatment in non-small cell lung cancer: an overview of new options
.
Anticancer Res
.
2011
Feb
;
31
(
2
):
649
59
.
[PubMed]
1791-7530
11.
Faller
BA
,
Pandit
TN
:
Safety and efficacy of vinorelbine in the treatment of non-small cell lung cancer.
Clinical Medicine Insights: Oncology
2011
;5:CMO. S5074.
12.
Gridelli
C
.
The ELVIS trial: a phase III study of single-agent vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer. Elderly Lung Cancer Vinorelbine Italian Study
.
Oncologist
.
2001
;
6
(
90001
Suppl 1
):
4
7
.
[PubMed]
1083-7159
13.
Chang
MH
,
Ahn
JS
,
Lee
J
,
Kim
KH
,
Park
YH
,
Han
J
, et al
The efficacy of pemetrexed as a third- or fourth-line therapy and the significance of thymidylate synthase expression in patients with advanced non-small cell lung cancer
.
Lung Cancer
.
2010
Sep
;
69
(
3
):
323
9
.
[PubMed]
0169-5002
14.
Ng
R
,
Loreto
M
,
Lee
R
,
Leighl
NB
.
Brief report: retrospective review of efficacy of erlotinib or gefitinib compared to docetaxel as subsequent line therapy in advanced non-small cell lung cancer (NSCLC) following failure of platinum-based chemotherapy
.
Lung Cancer
.
2008
Aug
;
61
(
2
):
262
5
.
[PubMed]
0169-5002
15.
Shepherd
FA
,
Rodrigues Pereira
J
,
Ciuleanu
T
,
Tan
EH
,
Hirsh
V
,
Thongprasert
S
, et al;
National Cancer Institute of Canada Clinical Trials Group
.
Erlotinib in previously treated non-small-cell lung cancer
.
N Engl J Med
.
2005
Jul
;
353
(
2
):
123
32
.
[PubMed]
0028-4793
16.
Paesmans
M
.
Prognostic and predictive factors for lung cancer
.
Breathe (Sheff)
.
2012
;
9
(
2
):
112
21
. 1810-6838
17.
Treasure
T
,
Utley
M
.
Survival after resection for primary lung cancer
.
BMJ Publishing Group Ltd
;
2006
.
18.
Chansky
K
,
Sculier
JP
,
Crowley
JJ
,
Giroux
D
,
Van Meerbeeck
J
,
Goldstraw
P
;
International Staging Committee and Participating Institutions
.
The International Association for the Study of Lung Cancer Staging Project: prognostic factors and pathologic TNM stage in surgically managed non-small cell lung cancer
.
J Thorac Oncol
.
2009
Jul
;
4
(
7
):
792
801
.
[PubMed]
1556-0864
19.
Gridelli
C
,
Perrone
F
,
Gallo
C
,
Cigolari
S
,
Rossi
A
,
Piantedosi
F
, et al;
MILES Investigators
.
Chemotherapy for elderly patients with advanced non-small-cell lung cancer: the Multicenter Italian Lung Cancer in the Elderly Study (MILES) phase III randomized trial
.
J Natl Cancer Inst
.
2003
Mar
;
95
(
5
):
362
72
.
[PubMed]
0027-8874
20.
Tatli
AM
,
Arslan
D
,
Uysal
M
,
Goksu
SS
,
Gunduz
SG
,
Coskun
HS
, et al
Retrospective analysis of third-line chemotherapy in advanced non-small cell lung cancer
.
J Cancer Res Ther
.
2015
Oct-Dec
;
11
(
4
):
805
9
.
[PubMed]
0973-1482
21.
Bennouna
J
,
Senellart
H
,
Hiret
S
,
Vaissiere
N
,
Douillard
JY
.
Impact of histology on survival of resected non-small cell lung cancer (NSCLC) receiving adjuvant chemotherapy: subgroup analysis of the adjuvant vinorelbine (NVB) cisplatin (CDDP) versus observation in the ANITA trial
.
Lung Cancer
.
2011
Oct
;
74
(
1
):
30
4
.
[PubMed]
0169-5002
22.
Nakamura
H
,
Ando
K
,
Shinmyo
T
,
Morita
K
,
Mochizuki
A
,
Kurimoto
N
, et al
Female gender is an independent prognostic factor in non-small-cell lung cancer: a meta-analysis
.
Ann Thorac Cardiovasc Surg
.
2011
;
17
(
5
):
469
80
.
[PubMed]
1341-1098
23.
Zhou
YT
,
Li
K
,
Tian
H
.
Effects of vinorelbine on cisplatin resistance reversal in human lung cancer A549/DDP cells
.
Asian Pac J Cancer Prev
.
2013
;
14
(
8
):
4635
9
.
[PubMed]
1513-7368
24.
Chu
DT
,
Kim
SW
,
Kuo
HP
,
Ozacar
R
,
Salajka
F
,
Krishnamurthy
S
, et al
Patient attitudes towards chemotherapy as assessed by patient versus physician: a prospective observational study in advanced non-small cell lung cancer
.
Lung Cancer
.
2007
Jun
;
56
(
3
):
433
43
.
[PubMed]
0169-5002
25.
Hirose
T
,
Horichi
N
,
Ohmori
T
,
Kusumoto
S
,
Sugiyama
T
,
Shirai
T
, et al
Patients preferences in chemotherapy for advanced non-small-cell lung cancer
.
Intern Med
.
2005
Feb
;
44
(
2
):
107
13
.
[PubMed]
0918-2918
26.
Matsuyama
R
,
Reddy
S
,
Smith
TJ
.
Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancer
.
J Clin Oncol
.
2006
Jul
;
24
(
21
):
3490
6
.
[PubMed]
0732-183X
27.
Crinò
L
,
Cappuzzo
F
,
Zatloukal
P
,
Reck
M
,
Pesek
M
,
Thompson
JC
, et al
Gefitinib versus vinorelbine in chemotherapy-naive elderly patients with advanced non-small-cell lung cancer (INVITE): a randomized, phase II study
.
J Clin Oncol
.
2008
Sep
;
26
(
26
):
4253
60
.
[PubMed]
0732-183X
28.
Frasci
G
,
Lorusso
V
,
Panza
N
,
Comella
P
,
Nicolella
G
,
Bianco
A
, et al
Gemcitabine plus vinorelbine yields better survival outcome than vinorelbine alone in elderly patients with advanced non-small cell lung cancer. A Southern Italy Cooperative Oncology Group (SICOG) phase III trial
.
Lung Cancer
.
2001
Dec
;
34
Suppl 4
:
S65
9
.
[PubMed]
0169-5002
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.