Journal of Clinical Oncology, Vol 14, 164-170, Copyright © 1996 by American Society of Clinical Oncology
Phase II trial of vinorelbine in metastatic squamous cell esophageal carcinoma. European Organization for Research and Treatment of Cancer Gastrointestinal Treat Cancer Cooperative Group
T Conroy, PL Etienne, A Adenis, DJ Wagener, B Paillot, E Francois, L Bedenne, JH Jacob, JF Seitz, H Bleiberg, C Van Pottelsberghe, M Van Glabbeke, FM Delgado, S Merle and J Wils
Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France.
PURPOSE: To evaluate the response rate and toxic effects of vinorelbine
(VNB) administered as a single agent in metastatic squamous cell esophageal
carcinoma. PATIENTS AND METHODS: Forty-six eligible patients with
measurable lesions were included and were stratified according to previous
chemotherapy. Thirty patients without prior chemotherapy and 16 pretreated
with cisplatin-based chemotherapy were assessable for toxicity and
response. VNB was administered weekly as a 25-mg/m2 short intravenous
(i.v.) infusion. RESULTS: Six of 30 patients (20%) without prior
chemotherapy achieved a partial response (PR) (95% confidence interval
[CI], 8% to 39%). The median duration of response was 21 weeks (range, 17
to 28). One of 16 patients (6%) with prior chemotherapy had a complete
response (CR) of 31 weeks' duration (95% CI, 0% to 30%). The overall
response rate (World Health Organization [WHO] criteria) was 15% (CR, 2%;
PR 13%; 95% CI, 6% to 29%). The median dose-intensity (DI) was 20 mg/m2/wk.
VNB was well tolerated and zero instances of WHO grade 4 nonhematologic
toxicity occurred. At least one episode of grade 3 or 4 granulocytopenia
was seen in 59% of patients. A grade 2 or 3 infection occurred in 16% of
patients, but no toxic deaths occurred. Other side effects were rare, and
peripheral neurotoxicity has been minor (26% grade 1). CONCLUSION: These
data indicate that VNB is an active agent in metastatic esophageal squamous
cell carcinoma. Given its excellent tolerance profile and low toxicity,
further evaluation of VNB in combination therapy is warranted.