Pharmacokinetics and tolerance of vinorelbine in elderly patients with metastatic breast cancer

Sorio, Roberto; Robieux, I.; Galligioni, Enzo; Freschi, Andrea; Colussi, A.M.; Crivellari, Diana; Saracchini, Silvana; Monfardini, S.

doi:10.1016/s0959-8049(96)00426-1

Cited by 72 publications

(21 citation statements)

References 9 publications

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“…Dose modification is needed only in patients with severe liver dysfunction. Sorio et al 23 reported that patients older than 65 years of age showed volume of distribution, terminal half-life, and systemic clearance rate that were similar to younger patients. No correlation was found with toxicity, age, or drug exposure.…”

Section: Vinca Alkaloidsmentioning

confidence: 97%

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Chemotherapy in the Elderly: Pharmacologic Considerations

Lichtman

Villani

2000

Cancer Control

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Section: Vinca Alkaloidsmentioning

confidence: 97%

“…It is approved for the treatment of metastatic non-small cell lung cancer and has activity in breast 23 and ovarian 24 cancer. Studies suggest that a dose of at least 20 mg/m 2 per week may be required for a response.…”

Section: Vinca Alkaloidsmentioning

confidence: 99%

Chemotherapy in the Elderly: Pharmacologic Considerations

Lichtman

Villani

2000

Cancer Control

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“…Responses were observed in 6 out of 20 evaluable patients (ORR 30%) and no correlation between dosage, age and toxicity was observed. 7 In another study, Vinorelbine was administered weekly at the same dosage (30 mg/m 2 ). The dose-limiting toxicity observed was hematologic, easily recovered with dose adjustment.…”

Section: Vinorelbine: Single Agent Activitymentioning

confidence: 99%

“…5,6 Pharmacokinetics in elderly patients (older than 65 years) is similar to those reported in younger people. 7 This report reviews the most important studies involving Vinorelbine in ABC with particular regard to the results of randomized trials in order to evaluate its role in this subset of patients.…”

Section: Introductionmentioning

confidence: 99%

A Review of Vinorelbine in the Treatment of Advanced Breast Cancer

Brunello

Roma

Basso

et al. 2009

Clinical Medicine. Therapeutics

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Abstract:Vinorelbine is a semi-synthetic vinca alkaloid that has been shown active in many tumor types and is currently registered for the treatment of advanced breast cancer (ABC) and non-small cell lung cancer (NSCLC), and it is used in other cancer type such as prostate cancer, lymphomas, gynecologic malignancies. This agent has a generally favorable safety profile, and may be suitable for use in special populations such as the elderly and/or frail patient. However, with the taxanes established as standard second line treatment for ABC after failure of an anthracycline, Vinorelbine has been generally relegated for use as third line therapy, in competition with the oral compound Capecitabine. Combination regimens of Vinorelbine and Gemcitabine have been indeed widely studied, and have been demonstrated to be safe and effective. More recently, the exciting results observed with the combination of Vinorelbine and Trastuzumab in patients with Her-2 overexpressing tumors, as well as the development of a reliable formulation and revised schedule of oral Vinorelbine appear to have revived the interest in this compound in the management of this disease. Yet, data from properly designed randomized clinical trials are eagerly awaited to confirm the amount of available data which are mostly based on phase II studies.

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“…Two studies of small sample size evaluated the impact of age on the pharmacokinetics of vinorelbine, and yielded conflicting results. Sorio et al (1997) studied the pharmacokinetics of vinorelbine in 10 patients age X65 and found no age-related change in pharmacokinetics or toxicity. In contrast, Gauvin et al (2000) evaluated the pharmacokinetics of vinorelbine in 12 patients age X65 and found a significant age-related decrease in vinorelbine clearance, estimated as a 30 -40% clearance decrease for patients age X70.…”

Section: Vinca Alkaloidsmentioning

confidence: 99%

Clinical pharmacology of cancer therapies in older adults

Hurria

Lichtman

2008

Br J Cancer

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This abbreviated review outlines the physiologic changes associated with aging, and examines how these changes may affect the pharmacokinetics and pharmacodynamics of anticancer therapies. We also provide an overview of studies that have been conducted evaluating the pharmacology of anticancer therapies in older adults, and issue a call for further research. (Yancik and Ries, 2000). As the general population ages and life expectancy increases, the number of older adults with cancer is growing.Several unique challenges arise in caring for older adults with cancer. In particular, the physiologic changes associated with aging can have an impact on the pharmacokinetics and pharmacodynamics of cancer therapies. The effects of these age-related changes on drug dosing and tolerance have been understudied, as clinical trials that set the standards for oncology care and drug approval have typically focused on a younger patient population (Hutchins et al, 1999;Talarico et al, 2004). Few studies have included patients who are frail or who have a poor performance status (Table 1).In this review, we provide an overview of the physiologic changes that accompany aging that may have an impact on the pharmacology of anticancer therapies. We also discuss recent studies evaluating the pharmacology of anticancer therapies in older adults. PHYSIOLOGIC CHANGES WITH AGINGAging is a heterogenous process; however, some characteristic changes in physiology and organ function can have an impact on the pharmacology of anticancer therapy. For example, age-related changes in the gastrointestinal tract may affect drug absorption. These changes include a decrease in splanchnic blood flow, gastrointestinal motility, secretion of digestive enzymes, and mucosal atrophy (Yuen, 1990;Baker and Grochow, 1997). With increasing age, hepatic mass decreases and there is a decrease in the cytochrome p450 content in liver biopsies, although the impact of these declines on hepatic function remains controversial (Sotaniemi et al, 1997;Shah, 2004;Sawhney et al, 2005).There is a decrease in renal mass and renal blood flow with aging (Vestal, 1997). These age-related changes in renal function could affect the pharmacology of anticancer drugs. A serum creatinine is often used to approximate renal function in younger adults; however, it is a poor indicator of renal function in older adults because of a decrease in muscle mass with age (FehrmanEkholm and Skeppholm, 2004). On average, the glomerular filtration rate decreases by approximately 0.75 ml min À1 year À1

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Pharmacokinetics and tolerance of vinorelbine in elderly patients with metastatic breast cancer

Cited by 72 publications

References 9 publications

Chemotherapy in the Elderly: Pharmacologic Considerations

Chemotherapy in the Elderly: Pharmacologic Considerations

A Review of Vinorelbine in the Treatment of Advanced Breast Cancer

Clinical pharmacology of cancer therapies in older adults

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