Vindesine. A review of phase-II trials.

Vindesine is a new vinca alkaloid with broad-spectrum antineoplastic activity in experimental tumor models. Phase-I studies have shown that a weekly dosage regimen of 3--4 mg/m2 IV produces manageable toxicity, with leukopenia and peripheral neuropathy being dose-limiting. Two hundred seventy-five patients have been enlisted in Phase-II trials at the Memorial Sloan-Kettering Cancer Center. Major objective responses (complete and partial remissions) were seen in bronchogenic carcinomas, melanoma, testicular carcinoma, esophageal carcinoma, acute lymphocytic leukemia, malignant lymphoma (Hodgkin's and non-Hodgkin's) and Wilms' tumor. Patients with hematologic and germ cell neoplasms were treated on a daily administration schedule (1.0--1.3 mg/m2 IV for 5--7 days). Vindesine was well tolerated, with less than 5% of patients having a WBC nadir of less than 1000 cells/mm3 and with a platelet-sparing effect noted. Dose-related peripheral neuropathy occurred frequently and was generally mild to moderate in degree. Vindesine appears to be an active agent whose role will be further defined by completion of ongoing trials.