Vinorelbine (Navelbine (R)) in the treatment of non-small-cell lung cancer: Recent developments in combination chemotherapy and radiotherapy

The investigation of the activity of vinorelbine in non-small-cell lung can cer (NSCLC) has continued beyond the initial studies which established its single agent activity and defined the combination of vinorelbine and cispla tin as one of the standard treatments for inoperable NSCLC. Alternative par tners to cisplatin have been evaluated in combination therapy with vinorelb ine with promising results emerging from combinations with carboplatin, ifo sfamide, mitomycin C and gemcitabine. Three drug combinations such as vinor elbine, cisplatin and ifosfamide can clearly produce high response rates in patients with good performance status at the time of treatment. The ability of vinorelbine to contribute to disease reduction either alone or in combination with other cytotoxic drugs has made it possible to consid er its use in neo-adjuvant therapy, while the synergistic action of vinorel bine with radiotherapy has encouraged the use of sequential or concomitant chemoradiotherapy producing high response rates after completion of both mo dalities. The possible role of post-operative adjuvant treatment with Vinor elbine either alone or in combination with cisplatin is being assessed in a prospective trial.