Clapper, Patti, Schweizer and Mason

Navelbine® is a semi-synthetic alkaloid partially derived from plants manufactured by Pierre Fabre Pharmaceuticals.  It is also one of the newest chemotherapy drugs available and shows promise as a first-line treatment for mesothelioma as well as a drug therapy for relapsed mesothelioma patients.  It was originally used to treat non-small cell lung cancer and breast cancer but researchers took notice of high response rates in patients and have expanded its usage in experimental clinical trials.  In one such trial, Navelbine® (vinorelbine) has been shown to halt tumor growth of malignant pleural mesothelioma and offer short periods of progression-free illness.

Navelbine® exhibits anti-mitotic properties, meaning the drug stops cancer cells from dividing.  This is critical in disrupting the replication process which undercuts that ability of tumors to grow and metastasize.  Navelbine® is useful by itself but because it is well tolerated by patients and exhibits relatively low toxicity, doctors often use Navelbine® in combination with other chemotherapy drugs as part of a multi-modal treatment.

However, studies examining the effectiveness and safety of vinorelbine and certain other chemotherapy drugs (specifically oxaliplatin) used in conjunction report similar results and higher toxicity.

Exciting clinical trials have shown that Navelbine® and its generic form vinorelbine produce measurable results in roughly ¼ of mesothelioma patients enrolled in the studies.  Other chemotherapy drugs, when used singularly, typically show positive effect in approximately 20% of mesothelioma patients.  Not only were the overall response rates higher, some of the patients enrolled in these vinorelbine studies showed progression-free survival for up to and slightly over 8 months.

Navelbine® is an injectable drug that is usually administered in 30 mg doses delivered intravenously.  Significant complications may arise if the drug is delivered incorrectly.  It is typically delivered in courses, for examply every eight days over a 21 day period.  The manufacturer also offers ingestible capsules but to date there have been no reliable studies on encapsulated Navelbine® and mesothelioma. 

Though relatively safe compared to other chemotherapy drugs, Navelbine® does come with some noticeable side effects that may affect up to 20% of patients.  These include:

• lowered resistance to infection, due to reduced immune cell counts
• increased bruising or bleeding
• nausea or vomiting
• fatigue
• decreased serum sodium levels (hyponatremia)
• constipation and other digestive issues

Though Navelbine® has been shown to be effective, its use is still limited and most mesothelioma doctors favor more traditional drug therapies such as cisplatin, carboplatin, or gemcitabine.