Yao Shuyang, Gu Yanfei, Zhang Yi
Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China.
Beijing United Family Healthcare Hospital, Beijing 100015, China.
Zhongguo Fei Ai Za Zhi. 2017 Nov 20;20(11):737-740. doi: 10.3779/j.issn.1009-3419.2017.11.03.
The development of new treatments beyond first-line in metastatic non-small cell lung cancer (NSCLC) contributed to the increase in overall survival. Metronomic chemotherapy involves several mechanisms of anti-tumor with less toxicity. Oral vinorelbine has paved the way for innovative treatment strategies through metronomic regimens. Therefore, this study assessed the efficacy and safety of metronomic oral vinorelbinen in advanced NSCLC after failure to multiple-lines treatments.
Our retrospective study enrolled 26 patients who received metronomic oral vinorelbinen. Survival factors were evaluated by univariate regression analysis.
The median follow-up time was 4 months (range 2-12). The median number of treatment cycles was 2 (range 1-8). No patient achieved complete remission, 2 cases (8%) partial remission, 11 cases (42%) stable disease, 13 cases (50%) progression disease. Overall response rate was 8% and disease control rate was 50%. The median progression-free survival (PFS) was 2 months. In univariate analysis, patients with performance status (PS)=1 had a statistically significantly longer PFS than patients with PS=2. Gender, age, smoking status and histology were not prognostic factors according to PFS. Treatment was well tolerated with rare serious toxicity. No grade 4 adverse events (AEs) or occurrences of intolerable toxicity were observed. There was no treatment-related death and none of the study patients required hospitalization for treatment-related adverse events.
CONCLUSIONS: Metronomic oral vinorelbinen is effective in advanced NSCLC after the failure of multiple lines treatments with an acceptable AE profile, especially in patients with high PS. .
转移性非小细胞肺癌（NSCLC）一线治疗以外新疗法的发展推动了总生存期的延长。节拍化疗具有多种抗肿瘤机制且毒性较小。口服长春瑞滨通过节拍给药方案为创新治疗策略铺平了道路。因此，本研究评估了节拍口服长春瑞滨在多线治疗失败后的晚期NSCLC患者中的疗效和安全性。
我们的回顾性研究纳入了26例接受节拍口服长春瑞滨治疗的患者。通过单因素回归分析评估生存因素。
中位随访时间为4个月（范围2 - 12个月）。中位治疗周期数为2个（范围1 - 8个）。无患者达到完全缓解，2例（8%）部分缓解，11例（42%）疾病稳定，13例（50%）疾病进展。总缓解率为8%，疾病控制率为50%。中位无进展生存期（PFS）为2个月。在单因素分析中，体能状态（PS）=1的患者的PFS在统计学上显著长于PS = 2的患者。根据PFS，性别、年龄、吸烟状态和组织学不是预后因素。治疗耐受性良好，严重毒性罕见。未观察到4级不良事件（AE）或不可耐受毒性的发生。没有与治疗相关的死亡，且研究患者中无人因治疗相关不良事件需要住院治疗。
节拍口服长春瑞滨在多线治疗失败后的晚期NSCLC患者中有效，不良事件可接受，尤其是在PS较高的患者中。
