II. Indications
- FDA Approved
- Off-Label
- Breast Cancer
- Cervical Cancer
- Hodgkin Lymphoma
- Mesothelioma (malignant, pleural)
- Ovarian Cancer
- Salivary Gland Cancer
- Small Cell Lung Cancer (refractory)
- Soft Tissue Sarcoma (advanced)
III. Mechanism
- See Mitotic Inhibitor Chemotherapy
- Vinorelbine is a semisynthetic Vinca Alkaloid, antineoplastic agent
- Vinorelbine is an antitubulin agent similar to the natural Vinca Alkaloids (e.g. Vincristine)
- Binds tubulin and inhibits microtubule formation
- Disrupts mitotic spindle formation
- Arrests cell cycle in M phase (metaphase)
- Other possible activity
- Interferes with metabolism of Amino Acids cAMP, glutathione
- Interferes with calmodulin-dependent Calcium transport ATPase activity
- Interferes with biosynthesis of Nucleic Acids and lipids
IV. Medications
- Vinorelbine Injection Solution: 10 mg/ml and 50 mg/5 ml vials
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects
- Alopecia
- Bronchospasm (and other pulmonary toxicity)
-
Peripheral Neuropathy
- Less neurotoxicity than other Vinca Alkaloids (lower affinity for nerve tubules)
- Severe skin and soft tissue necrosis on extravasation
- Vinblastine is a strong Vesicant (causes Blistering)
- Hepatotoxicity
- Increased Liver Function Tests
- Myelosuppression (Bone Marrow suppression)
- Granulocytopenia (including Neutropenia)
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
VIII. Resources
- Vinorelbine Injection Solution (DailyMed)
IX. References
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia