Efficacy of metronomic vinorelbine in elderly patients with advanced non-small-cell lung cancer and poor performance status

Abstract

Background Metronomic chemotherapy-administration of low-dose chemotherapy-allows for a prolonged treatment duration and minimizes toxicity for unfit patients diagnosed with advanced non-small-cell lung cancer (NSCLC). Methods Oral metronomic vinorelbine at 30 mg thrice weekly was given to 35 chemotherapy-naive patients who were elderly and vulnerable to toxicity and who had been diagnosed with advanced nsclc. Results Median age in this male-predominant cohort (29: 6) was 76 years (range: 65-86 years). Histology was squamous cell carcinoma in 21 patients and adenocarcinoma in 14. There were no complete responses and 9 partial responses, for an overall response rate of 26%. Stable disease was seen in 15 patients (43%), and 11 patients (31%) had progressive disease. the 1-year survival rate was 34%, and the 2-year survival rate was 8%. the survival analysis showed a median progression-free survival duration of 4 months (range: 2-15 months) and an overall survival duration of 7 months (range: 3-24 months). Conclusions Metronomic vinorelbine had an acceptable efficacy and safety profile in elderly patients with multiple comorbidities who had been diagnosed with advanced nsclc. Metronomic vinorelbine could be a treatment option for elderly patients with poor performance status who are unfit for platinum-based chemotherapy and intravenous single-agent chemotherapy, and who are not candidates for combination modalities.