Vinorelbine

In Madagascar, natives have traditionally made a tea out of the leaves of the periwinkle plant, vinca rosea. Scientists once thought that this tea was a potential cure for diabetes. Unfortunately, studies showed that the tea did not reduce blood sugar levels. However, it was found that an extract from the vinca rosea plant killed certain leukemia cells. Out of this research, the chemotherapy drugs Vincristine, Vinblastine, and Vinorelbine were created.

Vinorelbine, under the trade name Navelbine, is also known as Vinorelbine tartrate. It is classified among chemotherapy drugs as a plant alkaloid. It is currently approved for the treatment of non-small cell lung cancer and breast cancer. It is also prescribed for ovarian cancer and Hodgkin’s disease.

How Vinorelbine Works

Vinorelbine is known as an antimicrotubule agent. Microtubules are part of the cancer cell’s structure that is necessary for the cancer cell to divide and replicate itself. Vinorelbine works on the cancer cell during mitosis or cell division. By destroying the microtubule structures, Vinorelbine retards cell division. If the cancer cells cannot divide and replicate themselves, then the cancer stops growing.

Results of Phase II Clinical Trial of Vinorelbine on Mesothelioma

A research team based in the United Kingdom published “Phase II Study of Vinorelbine in Patients With Malignant Pleural Mesothelioma” in the Journal of Clinical Oncology in December, 2000. In this study, 29 patients with mesothelioma were given Vinorelbine and no other chemotherapy drugs. The results indicated that Vinorelbine is active against mesothelioma. Of these patients, 24% showed a partial response to the treatment; 55% showed stable disease; and 21% showed that their disease progressed in spite of the Vinorelbine.

One of the more significant aspects of this study was a quality of life assessment while receiving Vinorelbine. The study found that quality of life improved for the majority of the patients. Patients reported improvement in psychological, lung-related, and general physical symptoms.

The study concluded that further clinical trials with Vinorelbine in combination with other drugs were warranted given the positive response some of the patients received from the drug, the improved quality of life reported by many of the patients, and the minimal toxic side effects of the drug.

Active and Recruiting Mesothelioma Clinical Trials Involving Vinorelbine

Pharmaceutical manufacturer AstraZeneca is conducting a Phase II clinical trial that will compare the effectiveness of its new chemotherapy drug Vandetanib (trade name Zactima) against Vinorelbine. In this clinical trial, patients with inoperable or relapsed malignant mesothelioma will receive either Vandetanib or Vinorelbine as chemotherapy treatment. The primary purpose for this study is to evaluate how effective Vandetanib is in curing or controlling mesothelioma compared to Vinorelbine. A secondary purpose is to obtain further information about the safety of the drug Vandetanib.

In another Phase II clinical trial, the chemotherapy drugs Carboplatin and Vinorelbine will be used in combination to treat advanced malignant pleural mesothelioma. This Danish study will administer these drugs both orally and intravenously. The primary purpose of this study is to measure the response outcome from this combined regimen of Carboplatin and Vinorelbine.

Vinorelbine Used In Testing Chemotherapy Resistant Mesothelioma at International Mesothelioma Program

Physicians at the International Mesothelioma Program (IMP) at the Brigham and Women’s Hospital in Boston have developed a new test called the Extreme Drug Resistance (EDR) assay that indicates whether a person’s own mesothelioma is resistant to the standard chemotherapy drugs used in treating the disease. To do this EDR test, a surgeon at Brigham and Women’s Hospital removes a piece of the patient’s tumor. This tumor fragment is then cultured in the laboratory and exposed to various chemotherapy drugs – Cisplatin, Gemcitabine, a combination of Cisplatin and Gemcitabine, and Vinorelbine. It is then determined whether that individual’s mesothelioma is resistant to treatment by any of these drugs or drug combinations. Research indicates that if that person’s tumor is resistant to a particular drug in vitro or in the test tube, then it is very likely that the tumor in that person’s body will react the same way. This is an important step in making sure that each patient receives the right chemotherapy drugs to treat their own malignant mesothelioma.

Side Effects of Vinorelbine

The most significant side effect from taking Vinorelbine is neutropenia. Neutropenia means a low level of neutrofils, which are white blood cells made in bone marrow. This results in a lowered immune system. Other side effects are leucopenia (low white blood cell count), constipation, and phlebitis. Most patients do not experience significant hair loss, nausea, vomiting, and anorexia while on this drug.