Single agent vinorelbine as first-line chemotherapy in elderly patients with advanced breast cancer.
BACKGROUND
Breast cancer arises in about 48% of patients (pts) older than 65 years. Chemotherapy is administered to elderly pts with advanced breast cancer (ABC) resistant to hormonal treatment or with visceral metastases. Vinorelbine (VNR), a semisynthetic vinca alkaloid, is active and well-tolerated in ABC reporting, as a single agent, an objective response (OR) rate of 41%-60%. The ELVIS (Elderly Lung cancer Vinorelbine Italian Study) trial demonstrated the tolerability and efficacy of VNR in elderly pts with advanced non-small cell lung cancer (JNCI 91: 66-72, 1999).


METHODS
From January 1999 to December 2000, we analysed, retrospectively, our data about single-agent VNR as a first-line chemotherapy in elderly pts (> or = 70 years) with ABC. Twenty-four pts were analysed. VNR was administered at the dose of 30 mg/m2, i.v., days 1 and 8, every 3 weeks for a maximum of 6 cycles.


RESULTS
The main toxicity was (% of pts): grade (G) 3-4 neutropenia 25%; G 2 thrombocytopenia 4.1%; G 2 asthenia 25%; G 2-3 constipation 16.6%; and G 1 neurotoxicity 25%. No cycles of chemotherapy were omitted or postponed. Granulocyte colony-stimulating factor was administered in 12.5% of a total of 112 cycles. Nine (37.5%) objective responses (2 complete and 7 partial responses) were observed. The median duration of response and survival were 7 and 11 months, respectively.


CONCLUSIONS
These results suggest that single agent VNR is active and well-tolerated in elderly pts with ABC. Further prospective trials are warranted.
Rossi
Antonio
A
U. O. Oncologia Medica, Azienda Ospedaliera S. G. Moscati, Via Circumvallazione, 68, 83100, Avellino, Italy. arossi_it@yahoo.it
Gridelli
Cesare
C
Gebbia
Vittorio
V
Rosati
Gerardo
G
Tortoriello
Anna
A
Maione
Paolo
P
Borsellino
Nicola
N
Rossi
Nestore
N
Pisano
Agata
A
Colantuoni
Giuseppe
G
Iaffaioli
Rosario Vincenzo
RV
Castaldo
Vincenzo
V
Manzione
Luigi
L
D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D012189:Retrospective Studies; D014747:Vinblastine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000077235:Vinorelbine
D000972:Antineoplastic Agents, Phytogenic; D014747:Vinblastine; D000077235:Vinorelbine