title: On and off metronomic oral vinorelbine in elderly women with advanced breast cancer.
abstract: BACKGROUND
  Elderly patients with metastatic breast cancer (MBC) have more problems receiving chemotherapy than younger patients, especially with the presence of multiple comorbidities, adverse drug events and functional decline. Low-dose oral administration of cytotoxic agents such as vinorelbine, a semisynthetic vinca alkaloid that interferes with microtubule assembly, leading to arrest of cell division, is usually effective and well tolerated.
  
  
  METHODS
  From February 2010 to February 2014, 32 patients with MBC, median age 76 years (range 69-83) were treated with oral vinorelbine 30 mg (total dose), one day on and one day off, until disease progression or unacceptable toxicity levels were reported. Toxicity, quality of life and clinical benefit were evaluated. Matched t-tests were conducted to discern whether quality-of-life indicator (p&lt;0.05 was considered significant) differed before and 6 months after treatment. Statistical analysis was performed using Graph Pad Prism 5.0 (GraphPad Software Inc., San Diego, CA, USA).
  
  
  RESULTS
  No grade 3 and 4 adverse events were reported. A clinical benefit of 50% was found in our cohort. On and off metronomic vinorelbine oral administration resulted in good tolerability and safe profile in our selected elderly population, and improved patient adherence to therapy.
  
  
  CONCLUSIONS
  The present study demonstrated that metronomic vinorelbine might be a potential treatment in elderly patients by reducing adverse effects and increasing quality of life, setting the stage for future extensive clinical trials.
authors.affiliation: Experimental Medicine Department, Sapienza University of Rome, Rome - Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Iuliis
authors.forename: Gerardo
authors.initials: G
authors.lastname: Salerno
authors.forename: Ludovica
authors.initials: L
authors.lastname: Taglieri
authors.forename: Rosina
authors.initials: R
authors.lastname: Lanza
authors.forename: Susanna
authors.initials: S
authors.lastname: Scarpa
mesh_terms: D059250:Administration, Metronomic; D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000077384:Anastrozole; D018943:Anthracyclines / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D000069287:Capecitabine; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000188:drug therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077267:Fulvestrant; D006801:Humans; D000077341:Lapatinib; D000077289:Letrozole; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009570:Nitriles / Q000008:administration & dosage; D011799:Quinazolines / Q000008:administration & dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000077235:Vinorelbine
chemical_list: D000077384:Anastrozole; D018943:Anthracyclines; D061067:Antibodies, Monoclonal, Humanized; D000972:Antineoplastic Agents, Phytogenic; D014408:Biomarkers, Tumor; D000069287:Capecitabine; D003841:Deoxycytidine; D004958:Estradiol; D005472:Fluorouracil; D000077267:Fulvestrant; D000077341:Lapatinib; D000077289:Letrozole; D009570:Nitriles; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D043823:Taxoids; D000068878:Trastuzumab; D014230:Triazoles; D014747:Vinblastine; D000077235:Vinorelbine; C508053:ERBB2 protein, human