Annals of Oncology 10:397-402, 1999
© 1999 European Society for Medical Oncology
research-article |
Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older
1Comprehensive Cancer Research Group Inc. Miami, FL
2Greenville Cancer Center Greenville, SC
3Duke University Medical Center Durham, NC
4New York University Medical Center New York, NY
5The Genesee Hospital Rochester, NY
6Glaxo Wellcome Inc., Research Triangle Park NC, USA
Correspondence to: C. L.Vogel, MD, FACP, Concorde Centre II, 2999 NE 191st Street, Suite 200, Aventura, FL 33180, USA
Background: Older patients with advanced breast cancer are less likely to receive chemotherapy than younger patients. Vinorelbine is an attractive alternative in this setting because of its clinical activity and low frequency of side effects. This multicenter, phase II trial was designed to assess the safety and efficacy of intravenous vinorelbine as first-line therapy in women 
60 years old.
Patients and methods: Fifty-six women (median age, 72 years; range 60-84 years), with measurable advanced breast cancer and no prior chemotherapy for metastatic disease, were enrolled and included in the analysis. Vinorelbine 30 mg/m2was administered weekly for 13 weeks and then every two weeks until development of progressive disease; doses were reduced or delayed to manage toxicity.
Results: The objective response rate was 38% (95% confidence interval (95% CI): 24%-51%); median duration of response, nine months; median time to disease progression in all patients, six months. The major dose-limiting toxicity was hematologic, which led to a median dose intensity of 20.6 mg/ m2/week. Grade 3–4 nonhematologic toxicity consisted of asthenia (7%); nausea and generalized pain (5%); vomiting, chest pain, abdominal pain, and elevated AST (4%); fever, diarrhea, constipation, and injection site reaction (2%). Neuro-toxicity and alopecia were grade 1-2 and relatively infrequent.
Conclusions: Vinorelbine offers a promising alternative for the management of advanced breast cancer in elderly patients who are concerned about the subjective side effects of cytotoxic chemotherapy. The dose-limiting toxicity is neutropenia, which is readily managed with dose adjustment. Nonhematologic toxicity, including gastrointestinal side effects, is minimal. Randomized studies are warranted to compare the activity of vinorelbine with that of other regimens in elderly patients.
breast cancer, old age, vinorelbine
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