Vinorelbine in non-small cell lung cancer: Real-World data from a single institution experience

The use of vinorelbine as single agent or in combination regimens in NSCLC is associated with satisfactory clinical activity. However, the role of vinorelbine-based chemotherapy in chemonaive locally advanced unresectable or metastatic NSCLC patients, according to real-world treatment patterns, has still not widely explored. Eighty-one patient treated at a single institution were retrospectively analyzed. Thirty-seven received standard first-line single-agent vinorelbine, 44 vinorelbine plus platinum drugs, based on physician's choice. 61.7% were older than 70 years, 60.5% were affected by ≥2 comorbidities. Sixty-three patients were evaluable for objective response: 22% achieved partial response, 41% stable disease. Median progression-free survival (PFS) was 5.4 months. A benefit in PFS was observed in patients treated with combinations vs single-agent vinorelbine (6.7 vs. 3.5 months, p=0.043). Median overall survival (OS) was 10.4 months without a statistically significant difference between treatments (12.4 vs. 7.5 months). In 55 stage IV patients, OS was positively correlated with combination regimens, M1a stage, or ≤2 metastatic lesions. Grade 3-4 toxicity occurred in 33% of patients, dose reduction in 11%. A statistically significant higher incidence of toxicity was observed in patients receiving combinations, in women, in patients younger than 75 years, or with metastases. In this real-word analysis, we confirmed the efficacy and tolerability of vinorelbine single-agent or combined with platinums in patients usually underrepresented in controlled clinical trials. Single-agent vinorelbine may represent a suitable option in elderly or unfit NSCLC patients and warrants investigation as a potential drug candidate for immunochemotherapy combination regimens.