Vinorelbine

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Vinorelbine
Vinorelbine.svg
Vinorelbine ball-and-stick.png
Clinical data
Trade names Navelbine
AHFS/Drugs.com Monograph
MedlinePlus a695013
Pregnancy
category
  • AU: D
  • US: D (Evidence of risk)
Routes of
administration
intravenous, by mouth[1]
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 43 ± 14% (oral)[2]
Protein binding 79 to 91%
Metabolism liver (CYP3A4-mediated)
Biological half-life 27.7 to 43.6 hours
Excretion Fecal (46%) and kidney (18%)
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
Chemical and physical data
Formula C45H54N4O8
Molar mass 778.932 g/mol
3D model (Jmol)
 NYesY (what is this?)  (verify)

Vinorelbine (NVB), sold under the brand name Navelbine among others, is a chemotherapy medication used to treat a number of types of cancer. This includes breast cancer and non-small cell lung cancer.[3] It is given by injection into a vein or by mouth.[3][1]

Common side effects include bone marrow suppression, pain at the site of infection, vomiting, feeling tired, numbness, and diarrhea. Other serious side effects include shortness of breath. Use during pregnancy may harm the baby.[3] Vinorelbine is in the vinca alkaloid family of medications.[1] It is believed to work by disrupting the normal function of microtubules and thereby stopping cell division.[3]

Vinorelbine was approved for medical use in the United States in 1994.[3] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[4] The wholesale price in the developing world as of 2014 is between 18.10 and 42.82 USD per 50 mg vial.[5] This amount in the United Kingdom costs the NHS about 139.00 pounds.[1]

Medical uses[edit]

Vinorelbine is approved for the treatment of non-small-cell lung cancer. It is used off-label for other cancers such as metastatic breast cancer. It is also active in rhabdomyosarcoma.[6]

Side effects[edit]

Vinorelbine has a number of side-effects that can limit its use:

Chemotherapy-induced peripheral neuropathy (a progressive, enduring and often irreversible tingling numbness, intense pain, and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs[7]), lowered resistance to infection, bruising or bleeding, anaemia, constipation, vomitings, diarrhea, nausea, tiredness and a general feeling of weakness (asthenia), inflammation of the vein into which it was injected (phlebitis). Seldom severe hyponatremia is seen.

Less common effects are hair loss and allergic reaction.

Pharmacology[edit]

The antitumor activity is due to inhibition of mitosis through interaction with tubulin.[8] Vinorelbine is the first 5´NOR semi-synthetic vinca alkaloid. It is obtained by semi-synthesis from alkaloids extracted from the rosy periwinkle, Catharanthus roseus. It is marketed in India by Abbott Healthcare under the brand name Navelbine.

History[edit]

Vinorelbine was invented by the pharmacist Pierre Potier and his team from the CNRS in France in the 1980s and was licensed to the oncology department of the Pierre Fabre Group. It is a semi-synthetic vinca alkaloid. The drug was approved in France in 1989 under the brand name Navelbine for the treatment of non-small cell lung cancer. It gained approval to treat metastatic breast cancer in 1991. Vinorelbine received approval by the United States Food and Drug Administration (FDA) in December 1994 sponsored by Burroughs Wellcome Company. Pierre Fabre Group now markets Navelbine in the U.S., where the drug went generic in February 2003.

In most European countries, vinorelbine is approved to treat non-small cell lung cancer and breast cancer. In the United States it is approved only for non-small cell lung cancer.

Oral formulation[edit]

An oral formulation has been marketed and registered in most European countries. It has similar efficacy as the intravenous formulation, but it avoids venous toxicities of an infusion and is easier to take.[medical citation needed] The oral form is not approved in the United States or Australia.[medical citation needed]

References[edit]

  1. ^ a b c d British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 594. ISBN 9780857111562. 
  2. ^ Marty M, Fumoleau P, Adenis A, Rousseau Y, Merrouche Y, Robinet G, Senac I, Puozzo C (2001). "Oral vinorelbine pharmacokinetics and absolute bioavailability study in patients with solid tumors". Ann Oncol. 12 (11): 1643–9. doi:10.1023/A:1013180903805. PMID 11822766. 
  3. ^ a b c d e "Vinorelbine Tartrate". The American Society of Health-System Pharmacists. Retrieved 8 December 2016. 
  4. ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Retrieved 8 December 2016. 
  5. ^ "Vinorelbine". International Drug Price Indicator Guide. Retrieved 28 November 2015. 
  6. ^ Casanova, M; Ferrari, A; Spreafico, F; Terenziani, M; Massimino, M; Luksch, R; Cefalo, G; Polastri, D; et al. (2002). "Vinorelbine in previously treated advanced childhood sarcomas: Evidence of activity in rhabdomyosarcoma". Cancer. 94 (12): 3263–8. doi:10.1002/cncr.10600. PMID 12115359. 
  7. ^ del Pino BM. Chemotherapy-induced Peripheral Neuropathy. NCI Cancer Bulletin. Feb 23, 2010;7(4):6.
  8. ^ Jordan, M.A.; Wilson, L. (2004). "Microtubules as a target for anticancer drugs.". Nature Reviews. Cancer. 4 (4): 253–65. doi:10.1038/nrc1317. PMID 15057285.