Vinorelbine with or without Trastuzumab in Metastatic Breast Cancer

A. Stravodimou; K. Zaman; I.A. Voutsadakis

doi:10.1016/S0923-7534(20)32959-8

Background Vinorelbine is one of the most widely used drugs in metastatic breast cancer. We report a single center experience with vinorelbine with or without trastuzumab in patients with metastatic breast cancer. Patients and methods All patients with metastatic breast cancer receiving vinorelbine with or without trastuzumab during a six years period were retrospectively reviewed. Demographic data and data on response, time to progression (TTP) and survival were collected. Patients received vinorelbine IV 25-30 mg/m2or PO 60-80 mg/m2 in days 1 and 8 of a 21 days cycle. In patients who received concomitant trastuzumab a standard dosing schedule with 8 mg/kg loading dose followed by 6 mg/kg in subsequent administrations every three weeks was used. Results Eighty seven women were included. The median age was 63 years (range 32 to 85). Sixty two patients received vinorelbine alone and 25 patients received vinorelbine with trastuzumab. In 67 patients this was the first line treatment for metastatic disease and in 20 patients it was 2nd or later line of treatment. Seventy patients were evaluable for response while the remaining seventeen patients were not evaluable due to early progression (n = 6) or early termination of treatment for adversary effects (n = 11). The response rate of evaluable patients was 37.1% [1.4% Complete Response (CR) and 35.7% Partial Response (PR)]. Eighteen additional patients (25.7%) had Stable Disease (SD) for three or more months resulting in a Disease Control Rate of 62.8%. Twenty four of 54 (44.4%) patients receiving first line treatment had a response while in the second and subsequent lines setting two of 16 (12.5%) patients responded (x2 = 9.66, p = 0.001). A response was obtained in 63.6% of patients receiving concomitant trastuzumab and in 25% of patients receiving vinorelbine alone (x2 = 13.63, p = 0.0002). The median TTP was six months (range 1-45). Sixty six patients of the cohort have died and the median overall survival was 11.5 months (range 1-83). Adverse effects necessitating interruption of treatment were observed in 18.5% of patients. Conclusion This retrospective study of vinorelbine in metastatic breast cancer confirms a high disease control rate. Response rate is higher in first line treatment compared to subsequent lines and with the combination with trastuzumab. Disclosure

Vinorelbine with or without Trastuzumab in Metastatic Breast Cancer

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