Single agent vinorelbine in pediatric patients with progressive optic pathway glioma

J Neurooncol. 2015 Jan;121(2):405-12. doi: 10.1007/s11060-014-1652-6. Epub 2014 Nov 1.


The management of progressive unresectable low-grade glioma remains controversial. Treatment options have included radiotherapy, and more recently chemotherapy, usually following an initial period of observation. Within this context, we evaluated vinorelbine, a semi-synthetic vinca alkaloid that has shown evidence of activity against glioma. From July 2007 an institutional protocol with vinorelbine (30 mg/m(2) days 0, 8, 22) for a total of 18 cycles, has been conducted at IOP/GRAACC/UNIFESP for children with optic pathway glioma (OPG). The main objectives were clinical and radiological response, as well as toxicity profile. Twenty-three patients with progressive OPG with a mean age of 69 months (4-179) were enrolled. Three patients had a diagnosis of neurofibromatosis type 1. Twenty-two patients were assessable for response with an overall objective response rate of 63 %, with eight patients showing stable disease. The most important toxicity was hematologic (grade III/IV neutropenia) observed in four patients. Gastrointestinal toxicity (grade I/II vomiting) was observed in seven patients and only 1 patient showed grade I peripheral neuropathy. The median progression-free survival (PFS) was 33 months (6.9-69) with a 3 and 5 year PFS of 64 ± 19 and 37 ± 20 %, respectively, for an overall 3 and 5 year-survival of 95 ± 10 %. This study suggests that vinorelbine may be an interesting option for pediatric low-grade gliomas, showing low toxicity profile and providing a good quality of life for patients with such chronic disease.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adolescent
  • Antineoplastic Agents, Phytogenic / therapeutic use*
  • Antineoplastic Agents, Phytogenic / toxicity
  • Brain / drug effects
  • Brain / pathology
  • Brain / radiation effects
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Optic Nerve Glioma / drug therapy*
  • Optic Nerve Glioma / pathology
  • Optic Nerve Glioma / physiopathology
  • Optic Nerve Glioma / radiotherapy
  • Survival Analysis
  • Treatment Outcome
  • Vinblastine / analogs & derivatives*
  • Vinblastine / therapeutic use
  • Vinblastine / toxicity
  • Vinorelbine


  • Antineoplastic Agents, Phytogenic
  • Vinblastine
  • Vinorelbine