Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Oncol Res Treat. 2018;41(1-2):8-13. doi: 10.1159/000481098. Epub 2018 Jan 22.
Vinflunine is a microtubule inhibitor approved in Europe as second-line treatment of advanced transitional cell cancer of the urothelium (TCCU). The inability to continue with a first-line platinum-based regimen beyond 6 cycles suggested investigating the use of vinflunine as switch maintenance therapy in patients with response or stable disease after first-line therapy.
Patients with advanced TCCU and documented disease control after 3-6 cycles of first-line platinum-based chemotherapy received vinflunine maintenance therapy within 6 weeks of the last cycle. Our analysis aimed to examine the performance of vinflunine in terms of activity and safety in such a patient population.
28 consecutive patients were studied. After a median follow-up of 25 months, vinflunine was associated with a median progression-free survival of 9 months (range 4 to > 16 months) and a disease control rate of 64%; median overall survival was not reached. Treatment was well tolerated, with no unexpected safety events. The most common adverse events of grade ≥ 3 were neutropenia (21%) and constipation (14%); no toxicity-related death occurred.
Our results suggest that vinflunine may be a suitable maintenance treatment option for TCCU patients who received a maximum of 6 cycles of platinum-based chemotherapy commonly used as first-line treatment.
Vinflunine 是一种微管抑制剂，在欧洲被批准用于治疗晚期尿路上皮移行细胞癌（TCCU）的二线治疗。由于无法在 6 个周期后继续进行一线基于铂的方案治疗，因此建议在一线治疗后有缓解或疾病稳定的患者中，将 vinflunine 作为转换维持治疗。
接受过 3-6 个周期一线基于铂的化疗且有记录的疾病控制的晚期 TCCU 患者，在最后一个周期后 6 周内接受 vinflunine 维持治疗。我们的分析旨在检查 vinflunine 在该患者人群中的疗效和安全性。
28 例连续患者进行了研究。中位随访 25 个月后，vinflunine 与中位无进展生存期 9 个月（范围 4 至 > 16 个月）和疾病控制率 64%相关；中位总生存期未达到。治疗耐受性良好，无意外安全事件。≥3 级最常见的不良事件为中性粒细胞减少（21%）和便秘（14%）；无与毒性相关的死亡。
我们的结果表明，vinflunine 可能是一种适合接受过最多 6 个周期的铂类为基础的化疗（通常用作一线治疗）的 TCCU 患者的维持治疗选择。
