Vinorelbine for Mesothelioma

Important Facts About Vinorelbine for Mesothelioma

• Vinorelbine is not approved by the FDA for mesothelioma but is the focus of several past and present clinical studies for this cancer.
• Vinorelbine is an option as a replacement for cisplatin or pemetrexed. It’s also used on its own as an adjuvant therapy for advanced cases.
• Vinorelbine side effects include nausea, lower appetite, muscle aches and skin swelling at the infusion site.

What Is Vinorelbine?

Vinorelbine is the generic name for the brand chemotherapy drug Navelbine. It was approved in 1994 for general cancer treatment but isn’t approved yet for malignant mesothelioma.

Vinorelbine, a plant-based chemotherapy drug, is a vinca alkaloid. Its goal is to prevent cell division and replication, stifling how mesothelioma grows and spreads.

Vinorelbine interferes with cancer cells’ microtubule structures, which pull cells apart in the final stages of cell division. When these structures are blocked, the cells cannot replicate. They eventually die off before creating new cells, which is the goal of mesothelioma chemotherapy.

Vinorelbine is an option for patients enrolling in clinical trials, often after first‑line chemotherapy treatment failed. Most patients either have surgery or begin with FDA-approved chemotherapy or immunotherapy before taking vinorelbine.

Vinorelbine can work in tandem with many of the other chemotherapy drugs for mesothelioma, such as:

• Cisplatin
• Pemetrexed
• Carboplatin

Survival From Vinorelbine for Mesothelioma

Vinorelbine can improve survival for patients with mesothelioma. It can extend life for late-stage patients when FDA-approved chemotherapy or immunotherapy fails. Vinorelbine can also substitute for other mesothelioma chemotherapy medications when needed.

A study in the United Kingdom tested vinorelbine on patients who had a recurrence of mesothelioma following FDA-approved systemic chemotherapy. Vinorelbine prevented cancer spread for a median of 4.2 months, which was more than one month better than people receiving just supportive care.

Vinorelbine also was successful in past studies. Doctors used the drug with cisplatin in a 2008 study. The one‑year survival rate was 61%, and the two-year rate was 31%.

The median survival among 54 patients was 16.8 months, which outperforms cisplatin and pemetrexed by 2-4 months depending on the study. Nearly 30% of patients had some sort of response, meaning the disease either shrank or was killed completely.

Dosing of Vinorelbine

Dosing of vinorelbine varies by the study. Trials may also use a different number of cycles and doses per cycle. Vinorelbine is usually given intravenously. Some trials may test giving it via infusion.

For example, in the maintenance study comparing vinorelbine to supportive care, patients received 60 mg of vinorelbine each week (days 1, 8 and 15) during the first 21-day cycle. The dosage increased to 80 mg in the second cycle.

The study from 2008 used 25 mg doses of vinorelbine each week. The chemotherapy drug was infused over a 10-minute period.

In a phase 2 study from 2016, doctors gave patients 30 mg each week for an average of four cycles (with a high of 10 cycles). Most of the patients had an advanced case of mesothelioma (stage 3 or stage 4). Nearly 80% of patients had either stable disease or partial response to the therapy.

Vinorelbine Side Effects

Vinorelbine can cause many of the standard chemotherapy side effects, such as nausea and vomiting. Fatigue and weight loss are additional side effects to anticipate.

Others for vinorelbine include:

• Low blood counts
• Muscle weakness
• Constipation
• Diarrhea
• Burning or swelling at the site where the drug was given

How to Start Vinorelbine for Mesothelioma

If you’re interested in taking vinorelbine for mesothelioma, follow these three steps: