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Vinorelbine, also known by the brand name Navelbine, is a chemotherapy drug that has been tested as a second-line treatment for mesothelioma, both as a single agent and in combination with other drugs such as cisplatin or gemcitabine.
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Vinorelbine belongs to a family of chemotherapy drugs known as vinca alkaloids, which were initially created from extracts of the periwinkle plant. The antitumor effects of this drug were discovered in 1959.
Vinorelbine is classified as an antineoplastic agent. It binds to microtubular proteins in cells. Microtubules are needed for cell reproduction, so damage to the microtubules by vinorelbine prevents cancer cells from reproducing and leads to their self-destruction.
Used or Tested in: Breast cancer, cervical cancer, esophageal cancer, Hodgkin lymphoma, Kaposi’s sarcoma, mesothelioma, non-small cell lung cancer, ovarian cancer, testicular cancer
Vinorelbine is typically administered in cycles of six weekly intravenous (IV) injections, though this varies based on the patient’s health factors and whether vinorelbine is combined with another chemotherapy drug.
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Vinorelbine regimens are not as effective at extending survival as the standard pemetrexed and cisplatin treatment for mesothelioma. However, because vinorelbine has shown some effectiveness and has relatively low toxicity, doctors have continued to explore its value as a palliative or second-line therapy.
Palliative Therapy: Vinorelbine can relieve symptoms and improve quality of life for mesothelioma patients who cannot tolerate other cancer therapies.
Second-Line Therapy: Doctors may administer a regimen including vinorelbine to treat cancer reoccurrence after a patient has already received standard chemotherapy.
A 2017 review of second-line chemotherapy treatment for mesothelioma suggests even though international guidelines include vinorelbine as a suggested drug, the research evidence supporting its use is inconclusive.
In 2014, the Wales Cancer Trials Unit began a phase II clinical trial to further study the effectiveness of vinorelbine as a second-line treatment. The researchers also aim to determine whether the BRCA1 gene is required for vinorelbine to cause cancer-cell death.
A 2021 research study discovered that people with a BRCA1/MAD2L1 genetic deficiency may have decreased effectiveness with vinorelbine.
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