Combination chemotherapy with vinorelbine (Navelbine) and mitoxantrone for metastatic breast cancer: a review.

Trials establishing the safety and efficacy of single-agent vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Médicament, Paris, France) as first- and second-line chemotherapy for metastatic breast cancer led to testing of the combination of vinorelbine and mitoxantrone. Three phase II clinical trials in Europe and South America, and one phase I trial in the United States have studied the effects of this combination on advanced breast cancer. In the two phase II trials that used vinorelbine and mitoxantrone only, response rates were 56% for patients who received the combination as first-line therapy and 36% for those who were anthracycline resistant. A third phase II trial looked at the effects of a combination of mitoxantrone and vinorelbine plus ifosfamide with mesna in patients who had failed at least two prior chemotherapy regimens; a 41% response rate was noted. In the phase I trial, the combination of vinorelbine and mitoxantrone with prophylactic granulocyte colony-stimulating factors was explored. Further trials are needed to study the combination of vinorelbine and mitoxantrone.