title: Vinorelbine for non-small cell lung cancer.
abstract: BACKGROUND
  Vinorelbine is a 'third-generation' vinca alkaloid approved for the treatment of NSCLC. The introduction of 'third-generation' drugs (vinorelbine, gemcitabine, taxanes) in platinum combination improved survival of patients with advanced NSCLC, with substantially similar results among the different drugs. Treatment toxicities are considerable in this setting.
  
  
  METHODS
  This narrative review reports a synthesis of evidence available from published clinical trials, systematic reviews and meta-analyses on the activity and safety of vinorelbine, used as single agent or in combination chemotherapy in patients with NSCLC, from 1990 to 2009.
  
  
  RESULTS
  When vinorelbine was administered in a weekly schedule without interruptions, the most common toxicity was neutropenia that often precluded administration of the drug, therefore, reducing the dose intensity. A schedule providing administration of vinorelbine on days 1 and 8 every 3 weeks seemed to improve the tolerability of the drug. Tolerability of the drug did not result lower in the elderly subset. None of the other 'third-generation' drugs were clearly better tolerated than vinorelbine. Moreover, in the adjuvant setting, vinorelbine is the only third-generation drug that demonstrated, in combination with cisplatin, a consistent improvement in survival on a long-term basis.
  
  
  CONCLUSIONS
  Vinorelbine is an active and generally manageable therapeutic option for the treatment of both early and advanced NSCLC.
authors.affiliation: National Cancer Institute, Napoli, Italy.
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Piccirillo
authors.forename: Gennaro
authors.initials: G
authors.lastname: Daniele
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Maio
authors.forename: Jane
authors.initials: J
authors.lastname: Bryce
authors.forename: Gianfranco
authors.initials: G
authors.lastname: De Feo
authors.forename: Antonia
authors.initials: A
authors.lastname: Del Giudice
authors.forename: Francesco
authors.initials: F
authors.lastname: Perrone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morabito
mesh_terms: D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000378:metabolism; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D011838:Radiation-Sensitizing Agents / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014747:Vinblastine / Q000031:analogs & derivatives* / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077235:Vinorelbine
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D011838:Radiation-Sensitizing Agents; D014747:Vinblastine; D000077235:Vinorelbine