
Vinorelbine, or navelbine, is a vinca alkaloid drug that has been used to treat advanced sarcomas, in heavily pretreated patients.  

With LMS, navelbine seems to be used following upon a gemcitabine response that has progressed to resistance.  There have been three patients on the ACOR LMS List who have been placed on navelbine. 

Case 1 was a middle-aged male who had a partial response to Gemcitabine, but tumors grew after 3 months.  Navelbine was tried, but progression continued.

Case 2 is an older woman with low grade stage IV Uterine LMS.  She was unable to tolerate Gemcitabine because of gemcitabine-induced-hepatitis [two challenges].  She was placed on Navelbine, and had stable disease for 10 to 11 months.

Case 3 is an elderly lady with stage IV extremity LMS. She had a 10 or 11 month period of stable disease with Gemcitabine, then another 3 to 6 months of stable disease off chemotherapy.  She had a bad pulmonary reaction to the Navelbine, and stopped it.

"Vinorelbine also induced responses in patients who had become resistant to regimens that included other vinca alkaloids. Overall, Vinorelbine was well tolerated. Toxicity, including  neurologic toxicity, was mild and reversible. Neutropenia was the most frequent dose-limiting toxicity." 
&&url PMID: 10735904

Myelosuppression of all elements of the blood occurs.  Grade 3 to 4 Neutropenia in 63%, Grade 3 anemia in 9%, and Grade 3 thrombocytopenia in 3%.  Nonhematological toxicity [constipation and neurologic toxicity have been mentioned] was generally mild [less than Grade 3] and reversible.
&&url PMID: 12115359   
 
Further Information: &&url PMID: 9157072
