The efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with non-small cell lung cancer: a meta-analysis

Int J Clin Oncol. 2020 Sep;25(9):1624-1634. doi: 10.1007/s10147-020-01707-9. Epub 2020 May 29.

Abstract

Purpose: To evaluate the efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with stage IIIB/IV and advanced non-small cell lung cancer (NSCLC).

Methods: The PubMed, Embase, Cochrane library, Wanfang, and CNKI databases were searched for relevant studies. The overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and incidence of severe adverse events (grade ≥ 3 adverse events; grade 3/4 AEs) were calculated using the methods of merging ratios and means. Merged ratios and means and their 95% confidence intervals (CIs) were used to descriptively analyze the efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with stage IIIB/IV and advanced NSCLC.

Results: The ORR and DCR achieved with metronomic oral vinorelbine monotherapy were 12% (95% CI 5-20) and 48% (95% CI 38-59), respectively. Median PFS and OS were 3.46 months (95% CI 2.49-4.43) and 8.22 months (95% CI 7.21-9.24), respectively. The incidence of grade 3/4 AEs was 16% (95% CI 10-22). The more common grade 3/4 AEs were neutropenia 9% (95% CI 2-20) and leukopenia 8% (95% CI 1-19).

Conclusion: Metronomic oral vinorelbine monotherapy has a certain effect on patients with stage IIIB/IV and advanced NSCLC, especially for untreated elderly patients. It offers the advantages of convenience, lower cost and acceptable incidence of severe adverse events.

Keywords: Meta-analysis; Metronomic chemotherapy; NSCLC; Vinorelbine.

Publication types

  • Meta-Analysis

MeSH terms

  • Administration, Metronomic
  • Antineoplastic Agents, Phytogenic / administration & dosage*
  • Antineoplastic Agents, Phytogenic / adverse effects
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Clinical Trials as Topic
  • Humans
  • Leukopenia / chemically induced
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Neutropenia / chemically induced
  • Progression-Free Survival
  • Treatment Outcome
  • Vinorelbine / administration & dosage*
  • Vinorelbine / adverse effects

Substances

  • Antineoplastic Agents, Phytogenic
  • Vinorelbine