Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older

C. L. Vogel, M. O'Rourke, E. Winer, H. Hochster, Alex Y Chang, B. Adamkiewicz, R. White, C. McGuirt

Research output: Contribution to journalArticle

Abstract

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/m2 was 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%). Neurotoxicity 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.

Original languageEnglish (US)
Pages (from-to)397-402
Number of pages6
JournalAnnals of Oncology
Volume10
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

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Breast Neoplasms
Drug Therapy
Social Adjustment
Asthenia
Alopecia
Constipation
Neutropenia
Chest Pain
Nausea
Abdominal Pain
Vomiting
Disease Progression
vinorelbine
Diarrhea
Fever
Confidence Intervals
Safety
Pain
Injections
Therapeutics

Keywords

  • Breast cancer
  • Old age
  • Vinorelbine

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Vogel, C. L., O'Rourke, M., Winer, E., Hochster, H., Chang, A. Y., Adamkiewicz, B., ... McGuirt, C. (1999). Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older. Annals of Oncology, 10(4), 397-402. https://doi.org/10.1023/A:1008364222793

Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older. / Vogel, C. L.; O'Rourke, M.; Winer, E.; Hochster, H.; Chang, Alex Y; Adamkiewicz, B.; White, R.; McGuirt, C.

In: Annals of Oncology, Vol. 10, No. 4, 1999, p. 397-402.

Research output: Contribution to journalArticle

Vogel, CL, O'Rourke, M, Winer, E, Hochster, H, Chang, AY, Adamkiewicz, B, White, R & McGuirt, C 1999, 'Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older', Annals of Oncology, vol. 10, no. 4, pp. 397-402. https://doi.org/10.1023/A:1008364222793
Vogel, C. L. ; O'Rourke, M. ; Winer, E. ; Hochster, H. ; Chang, Alex Y ; Adamkiewicz, B. ; White, R. ; McGuirt, C. / Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older. In: Annals of Oncology. 1999 ; Vol. 10, No. 4. pp. 397-402.
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AU - Vogel, C. L.

AU - O'Rourke, M.

AU - Winer, E.

AU - Hochster, H.

AU - Chang, Alex Y

AU - Adamkiewicz, B.

AU - White, R.

AU - McGuirt, C.

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N2 - 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/m2 was 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%). Neurotoxicity 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.

AB - 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/m2 was 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%). Neurotoxicity 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.

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