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An individual patient-data meta-analysis of metronomic oral vinorelbine in metastatic non-small cell lung cancer.

Abstract : INTRODUCTION: Several non-comparative phase II studies have evaluated metronomic oral vinorelbine (MOV) in metastatic non-small cell lung cancer (NSCLC) but the small size of each study limits their conclusions. PURPOSE: To perform an individual patient-data metaanalysis of studies evaluating MOV in metastatic NSCLC in order to measure survival and safety of treatment with this regimen. METHODS: Studies were selected if (1) administration of oral vinorelbine thrice a week; (2) fixed daily dose comprised between 30 and 50 mg, and; (3) being published before October 4th 2018. Database encompassed 8 variables characterizing disease and demography, 3 informing therapy, and 12 describing survival and toxicity. RESULTS: Nine studies encompassing 418 patients fulfilled the selection criteria, 80% of them having frailty characteristics. Median overall survival (OS) was 8.7 months (95%CI: 7.6-9.5). OSrates at 6 months, one year and at two years after starting vinorelbine were 64%, 30.3% and 8.9%, respectively. In the Cox model, Eastern Cooperative Oncology Group (ECOG) performance status (PS) = 2, and anemia of any grade were significant determinants of shorter OS. Median progression-free survival(PFS) was 4.2 months (95%CI: 3.9-5). At 6 months and at one-year, PFS rates were 35% and 11.9% respectively. In the Cox model stratified for the variable "study", PS = 2and stage IV were significant determinants of shorter PFS. No toxicity was reported for 40% of patients, and 66 (15.8%) patients experienced a grade 3-4 toxicity. The most frequent toxicity was anemia of any grade (35.8%) that was higher with the 50 mg dosage. CONCLUSION: MOV is an active and well-tolerated chemotherapy in metastatic NSCLC and is a manageable therapy in frail patients.
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Soumis le : mercredi 6 mai 2020 - 10:16:24
Dernière modification le : vendredi 15 mai 2020 - 12:22:09

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Jean-Louis Pujol, Amandine Coffy, Andrea Camerini, Athanasios Kotsakis, Manlio Mencoboni, et al.. An individual patient-data meta-analysis of metronomic oral vinorelbine in metastatic non-small cell lung cancer.. PLoS ONE, Public Library of Science, 2019, 14 (8), pp.e0220988. ⟨10.1371/journal.pone.0220988⟩. ⟨hal-02565022⟩

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