Annals of Oncology Advance Access originally published online on April 27, 2005
Annals of Oncology 2005 16(8):1352-1358; doi:10.1093/annonc/mdi243
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© 2005 European Society for Medical Oncology
Vinorelbine and prednisone in frail elderly patients with intermediate-high grade non-Hodgkin's lymphomas
1 Division of Medical Oncology, Azienda Ospedale Università, Padova; 2 Division of Hematology, Hospital ‘S. Camillo’, Roma; 3 Division of Medical Oncology, Hospital of Vittorio Veneto; 4 Cattedra di Ematologia, Parma, Italy; 5 Division of Hematology, Hospital of Novara; 6 Division of Hematology, Hospital of Trento; 7 Mario Negri Istituto, Milano, Italy
* Correspondence to: Prof. S. Monfardini, Division of Medical Oncology, Azienda Ospedale Università Padova, Ospedale Busonera, via Gattamelata 64, 35100 Padova, Italy. Tel: +39-049-8215931; Fax: +39-049-8215932; Email: silvio.monfardini{at}unipd.it
Background:: Frail patients with non-Hodgkin's lymphoma (NHL) are generally excluded from clinical trials and not even treated. The aim of this study was to evaluate the efficacy and tolerability of vinorelbine and prednisone in frail elderly patients with NHL.
Patients and methods:: Thirty consecutive frail elderly patients were entered in a phase II study with vinorelbine 25 mg/m2 i.v. on days 1 and 8 and oral prednisone 30 mg total dose on days 1–8 for six cycles. Criteria of frailty were age 
80 years, or age 70 years and three or more comorbidities of grade 3 or at least one comorbidity of grade 4 according to the Cumulative Illness Rating Scale (CIRS), or not self-sufficient or the presence of one or more geriatric syndromes.
Results:: Of 30 evaluable patients, three (10.0%) achieved a complete response (CR), nine (30.0%) showed a partial response (PR), while 10 presented with stable disease and eight with progressive disease. The median duration of CR was 29 months (range 5–36 months), and the median duration of PR was 1 month (range 1–22 months). Three patients had grade 3 neutropenia and one had grade 4. One grade 4 neurotoxicity was observed. Three patients died because of heart failure within 28 days of therapy, and one patient died after 4 days because of rapid progression. The median overall survival was only 10 months.
Conclusion:: Vinorelbine and prednisone is a relatively non-toxic combination with modest activity in frail patients with NHL. If initial aggressive chemotherapy has been excluded, this combination could be tried to obtain a temporary palliation.
Key words: combination chemotherapy, elderly patients, frailty, non-Hodgkin's lymphoma, prednisone, vinorelbine
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  S. M. Lichtman, H. Wildiers, E. Chatelut, C. Steer, D. Budman, V. A. Morrison, B. Tranchand, I. Shapira, and M. Aapro International Society of Geriatric Oncology Chemotherapy Taskforce: Evaluation of Chemotherapy in Older Patients--An Analysis of the Medical Literature J. Clin. Oncol., May 10, 2007; 25(14): 1832 - 1843. [Abstract] [Full Text] [PDF]
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 U. Tirelli, M. Balzarotti, L. Uziel, A. J. M. Ferreri, A. Santoro, M. Spina, and On behalf of the G.O.L. (Gruppo Oncoematologico Li Vinorelbine and prednisone in frail elderly patients with intermediate-high grade non-Hodgkin's lymphomas Ann. Onc., March 1, 2006; 17(3): 533 - 533. [Full Text] [PDF]
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