Respiratory toxicity of combined vinorelbine-mitomycin chemotherapy

The respiratory toxicity, of vinca alkaloids only appears when they are ass ociated with mitomycin. Few reports have been noted with vinorelbine, the l ast molecule of this class. We report 4 cases of acute dyspnea induced by t he association mitomycin-vinorelbin. The 4 patients were treated for lung c ancer. At the end of the injection of vinorelbin appeared an acute bronchos pasm. In 3 cases, the symptoms disappeared with broncho-dilatators and cort icoids. The fourth patient needed an additional respiratory support. After the acute syndrome, a chronic respiratory insufficiency developed in three patients. Two patients required continuous oxygenotherapy. The pulmonary toxicity of the mitomycin-vinca alkaloids association is cara cterized by an acute dyspnea. The dyspnea appears within 2 hours after the end of the administration of vinorelbine. The frequent existence of airflow obstruction in patients with lung cancer exposes to high risk of severes i ncidents. These treatments must be stopped at onset of the first pulmonary symptom. The association of mitomycin with vinorelbine (as for all vinca al kaloids) in chemotherapy protocols for treatment of non-small-cell lung can cer should not be indicated because there is an increase of the toxicity wi thout increase of efficiency.