Vindesine, a vinca alkaloid derived from vinblastine, has been examined for activity against a variety of solid and hematological malignancies. Single-agent response rates average 18% in non-small cell lung cancer and it has been widely used in combination with cisplatin as first-line therapy for this disease. It has limited activity in breast cancer (average 16% response rate) and does not appear to improve outcome when combined with anthracyclines. Vindesine is frequently incorporated into combination regimens for the treatment of malignant melanoma, and head and neck cancer, although its single-agent activity in these diseases is modest (average 14 and 12% response rates, respectively). Its activity in the hematological malignancies appears to be greater and it has an important role in the treatment of acute lymphoblastic leukemia, particularly in children. It is currently being examined for its potential to synergize with the interferons and for its value as prolonged therapy in preventing metastasis.