AB006. Metronomic oral vinorelbine monotherapy in elderly patients with advanced NCSLC

Background: Metronomic chemotherapy involves chronic administration of low-dose chemotherapy at regular short intervals, with the aim to induce prolonged cancer control without significant side effects. Aim was to evaluate metronomic oral vinorelbine in elderly patients with advanced NSCLC.

Methods: Chemotherapy naïve patients with a mean age of 72.8 yrs with NSCLC stage IIIB-IV and PS 0–2 were enrolled in this trial. Vinorelbine was administered orally at a dose of 40 mg three times a week, until disease progression or unacceptable toxicities occurred.

Results: Thirty-four patients were enrolled (19 adenoca, −14 squamous cell carcinoma, −1 NSCLC). Thirty were eligible for evaluation. Ten pts 33.3% had PS 2 and 7 (23.3%) had comorbidities (COPD and/or Heart failure). A partial response was observed in 6 patients (20%) and 12 (40%) had stable disease. After a median follow up period of 24.2 months, the median progression-free survival (PFS) period was 7.00 months (95% CI, 4.9–9.1 months). No significant difference was found in in PFS between patients with adenoca and squamous cell carcinoma (5.00 vs. 6.39 months, P>0.05). Four patients (13.3%) showed a clinical improvement changing their PS from 2 to 1. Most adverse events were grade 1–2 (peripheral neuropathy, diarrhea and nephrotoxicity) and there was no need for dose reduction or discontinuation of vinorelbine.

Conclusions: Considering the PFS period and the negligible toxicity metronomic oral vinorelbine seems to be a useful and safe therapeutic option for elderly patients with advanced NSCLC.

Keywords: Chemotherapy; lung cancer; oral vinorelbine