Vinorelbine for recurrent adenocarcinoma-like salivary gland malignancies

Orai Oncol, I&J Cancer, Vol. 32B, No. 3, pp. 213-214, 1996 Copyright 1996 Elsrv~r Saence Ltd. All rights reserved Printed in Great Br~tarn 0964-1955;96 $15.00+0.00

c

Pergamon 0964-1955(95)00088-7

Letter Vinorelbine

for Recurrent Adenocarcinoma-like Gland Malignancies

M. Airoldi,’ C. Bumma,’ 0. Bertetto,’ ‘Department 2Department

Vinorelbine

(VNB),

a new semisynthetic

to be effective

cancer,

cisplatin-resistant

in non

In recurrent

vinorelbine patients

small

ovarian

[l]

and very

cell head activity

cancer,

and neck

Age (years) Median Range

cancer,

= 17”,,) as first

in heavily

This

study in

tumours

evaluated patients

of major

the with

and minor

was administered

efficacy

of VNB

recurrent salivary

as palliative

adenocarcinoma-like

gland origin.

at a dose of 30 mgjm’

intravenously

The drug was administered withheld

had

grade

was discontinued

(i.v.)

Patients

if grade

received was

treatment.

at least 18 weeks.

treatment

Patients

April

1993

progression

117 courses

of VNB

All patients

response

(PR)

duration (PD) better

where given;

adenoid

cystic

retreatment no

of 3 months

(43”,,).

or

Patients

response

an objective

response

14 patients

(median

per patient:

for response

Overall, 9; range a partial

in one of these

was effective

at

and the

7 months. (NC)

(2.5-lo+)

(43”,,)

Correspondence to M. Airoldi. Received 30 Aug. 1995; provisionally manuscript received 2 Nov. 1995.

a median

and 6 progressive

with performance 7111;

with

55”,,)

status than

disease

(F’S) O-l patients

6 Oct.

12 2

+ novantrone

had

3 10 1

Site of recurrence Local Local + metastases Metastases only

5 1 8

Site of metastases Lung Lung + bone Lung + bone + lymph-node

6 2 1

+ skin

with PS=2

accepted

3 8 3

Histology Adenocarcinoma Adenoid cystic carcinoma Malignant mixed tumour

and toxicity.

achieved

3-6 + months, with VNB

were

had clear evidence

carcinoma

change

(PR+NC;

of for

or toxicity. 1994,

status

Site of primary tumour Parotid gland Submandibular gland Hard palate Buccal mucosa Base of tongue Maxillary sinus

unless

weeks

treatment

at the start of chemotherapy.

were evaluable

had

4

1). All patients

had a new PR lasting

6 patients

9 weeks

least

9 5

Prior therapy Surgery + radiation Surgery + radiation

was

hepatic,

at

progression

(14” ,,) lasting

the progression, patient

dose

Treatment

at least

after

to December

of a tumour

with

for

who achieved

until

in the study (Table

2 patients

neutropenia.

with stable disease continued

treatment

From

planned treatment

to IV neurological,

documented

Patients

continued

III

and

occurred.

progression

6-19).

at half the initially neutropenia

in the event of grade III-IV

renal toxicity

entered

II

60 27-74

ECOG performance PS 0 PS 1 PS 2

Vinorelbine

weekly. if patients

(n = 14)

Sex Male Female

pretreated

[2].

therapy

characteristics

breast

and Hodgkin’s

(O.R.

low efficacy

Table 1, Patient

vinca alkaloid, has

cell lung

carcinoma

squamous

has shown moderate

line therapy

G. Succo3 and M. Bussi

of Medical Oncology, S. Giovanni Antica Sede Hospital, Via Cavour 31, 10123 Torino; of Radiotherapy; ‘I ENT Department; and 411 ENT Department, University of Turin, Via Genova 3, 10126 Torino, Italy

proven disease.

A.M. Riella,’ P. Gabriele,’

Salivary

1995; revised

213

(l/3;

33”,,).

Patients

slightly

better

response

adenoid

cystic

carcinoma

with

adenocarcinoma

(Z/3 PR+

NC)

(6/10).

Patients

than

showed

patients

who

had

a

with a local

M. Airoldi

214 relapse

had the same response

metastases

(5/8). The

trone

no response.

had

months

for PR/NC

median

overall

pain before Among

The

III

observed

in 5.1”,,;

grade

in 12 (10.2”,).

In conclusion, that VNB

The

has some

antitumour

gland malignancies;

metastases

apparent

survival

was frequently Cisplatin

we will

results

1. Romanini

IV

II in 7.7”,,

2.

in ten

I neurotoxicity

was

3.

in 2 patients

activity

in adenocarcinomacystic

Despite

palliation

and toxicity

the

are probably

carcinoma

with

absence

of an

of pain and local disease

pronounced.

is one of the most active

4.

of our study suggest

the poor results

[4-61;

investigate salivary

has shown a clinical

synergistic

for these reasons,

in our future

this

combination

in recurrent

gland malignancies.

in

I leuco-

was reported

was well tolerated

of adenoid

(9 patients). benefit,

grade

constipation

preliminary

due to the high percentage distant

studies

in 1 (7.1”,,).

the treatment

was manageable.

in many tumours

had

or grade

grade

with VNB

activity

adenocarcinoma-like

in four cycles (3.4”,,)

Grade

and its combination

in pain was

death

(19”(,),

I nausea

(7.1”,,);

10

was reduced.

cycles,

grade I thrombocytopenia

in one patient

was

(64”,,)

reduction

No drug-related

and a mild alopecia

like salivary

9 patients

assumption

in 22/l 17 cycles

and local phlebitis (14.2(‘,,)

drugs

time

for non-resp0ndr:r.s;

In 117 administered

penia was observed and grade

survival

in distant with novan-

on pain were constant

a transient

in 2/4 patients.

cycles (8.5”,,),

median 3.7 months

Results

analgesic

occurred.

treated

was 7 months.

non-responders,

achieved toxicity

survival

(519):

previously

patients,

chemotherapy.

responders

rate (3/6) observed

patients

et al.

drug in this histology

[3]

5.

6.

A, Surbone A, Ricci S, Come PF. Phase-II studv of continuous infusion of vinorelbine (CIV) in patients with locally pretreated advanced head and neck cancer. Proc Annu Meet Am Assoc Cancer Res 1993, 34A, 1222. Testolin A, Recher G, l’ozza F, Panizzoni GA, Gasparini G. Vinorelbine (VNB) in pretreated advanced head & neck squamous cell carcinoma (AN&NSCC): a phase II study. Proc Am Sot Cl& Oncol 1994, 13, abstract 938, 289. Airoldi M, Brando V, Giordano C, Gabriele I’, Bussi M, Cortesina G. Chemotherapy for recurrent salivary gland malignancies: experience of the ENT Department of Turin University. ORL 1994, 56, 105-l 11. Depierre A, Lemaire E, Dabouis G, et al. Efficacy of navelbine (VNB) in non small cell lung cancer (NSCLC). Semin Oncol 1989, 16 (Suppl 4), 26-29. Gebbia V, Valenza R, Testa A, Cannata G, Verderame F, Gebbia N. Vinorelbine plus cisplatin in advanced squamous cell head and neck carcinoma (SCHNC). Proc Fifth Int Gong Anti-Cancer Treat Paris 1995, abstract 064, 96. Gebbia V, Mantovani G, Farris A, et al. Vinorelbine (VNR), cisplatin (CDDP), and 5-fluorouracil(5FU) as initial treatment for squamous cell carcinoma of the head and neck: results of a phase II multicenter study. Ann Oncoll994,S (Suppl B), abstract P586,116.