Clapper, Patti, Schweizer and Mason

According to a study by the Department of Medical Oncology at St Bartholomew's Hospital and the London Lung Cancer Group, Vinorelbine, marketed as Navelbine®, may play some part in fighting mesothelioma in the near future.   The two organizations examined vinorelbine as a first-line treatment for malignant pleural mesothelioma and hint that it may prove an effective second-line therapy as well. 

The study was designed specifically to evaluate patients’ responses to vinorelbine, paying specific attention to self-reported quality of life.  Twenty nine patients were given injection treatments in cycles of 30 mg/m(2) weekly for a six week period.  All of the patients had been diagnosed with histologically proven pleural mesothelioma and were between the ages of 29 and 77.  All of the patients except three were male.  Seventeen had been diagnosed with epithelial mesothelioma, the most treatable and responsive form of the disease, while 10 had been diagnosed with biphasic.  The remaining two were suffering from sarcomatoid mesothelioma. 

The patients were evaluated at the beginning of the experiment using the International Mesothelioma Interest Group staging to assess how far their cancer had developed.  Only one patient was assessed as being in stage I, 10 were in stage II, and 8 in stage III.  Longest chances of survival from mesothelioma and all types of cancer is Stage I or II.

The patients were also given spiral computed tomography scans (CT Scans) and the size, shape, and orientation of their tumors were measured.  This original measurement was used as a starting point to assess the effectiveness of the drug therapy when compared to post-treatment CT Scans.

Surprisingly, 23 of the patients responded to treatment with vinorelbine.  Seven had what researchers considered partial responses.  In these cases tumor growth had slowed but not stopped.  Sixteen patients experienced “stable disease,” meaning their tumors did not grow at all and the cancer did not metastasize to other parts of the body.  Only six of the patients experienced cancer progression during treatment. 

In addition to the direct effects on the mesothelioma tumors, the patients’ self-assessments reported a higher quality of life after treatment with vinorelbine. 

These results led researchers to conclude that first-line treatment with vinorelbine did indeed warrant further research.  They went on to speculate that adding vinorelbine to concurrent treatment with other mesothelioma drugs may indeed provide an even higher response rate.  In addition, vinorelbine proved to be significantly less toxic than many anti-cancer drugs currently available. 

Source:  Phase II study of vinorelbine in patients with malignant pleural mesothelioma.