Prostate cancer is a malignant disease that affects men’s reproductive system. The prostate gland is located below the bladder, near the rectum and surrounding the urethra, and when it is affected by cancer, the cells of the prostate start to grow out of control. Despite the high incidence of the disease, there are treatment options to address it. These include watchful waiting or active surveillance, surgery, radiation therapy, cryotherapyhormone therapy, vaccine treatment, bone-directed treatment, and chemotherapy.

Chemotherapy is a treatment option based on the injection of anti-cancer drugs into a vein or through its administration by ingestion to kill the cancerous cells. It is not usually the first course of treatment for patients with prostate cancer, but it may be an option for patients whose cancer has metastasized to other organs or when hormone therapy is no longer working. Docetaxel (Taxotere®), Cabazitaxel(Jevtana®), Mitoxantrone (Novantrone®), Estramustine (Emcyt®), Doxorubicin(Adriamycin®), Etoposide (VP-16), Vinblastine (Velban®), Paclitaxel (Taxol®), Carboplatin (Paraplatin®), and Vinorelbine (Navelbine®) are the drugs approved for chemotherapy in the USA.

How Vinorelbine Works

Vinorelbine is an anti-cancer drug classified as ditartrate salt of a semisynthetic vinca alkaloid, since it derives from the leaves of the periwinkle plant (Vinca rosea). The compound has antineoplastic activity, which means that it binds to tubulin, resulting in the inhibition of tubulin polymerization into microtubules and spindle formation. Given the correlation between mitotic microtubules inhibition and anti tumor activity, vinorelbine is able to cause the death of cancerous cells. Vinorelbine is also more selective against mitotic than axonal microtubules in vitro, compared to other vinca alkaloids.

“Vinorelbine (Navelbine) is a new vinca alkaloid with superior efficacy compared to older drugs such as vincristine, vinblastine, and vindesine. Unlike the older vinca alkaloids, neuromuscular toxicity is not a major problem. However, myelosuppression (especially granulocytopenia) is the major dose-limiting toxicity. Nonmyelosuppressive toxicity is minimal, although venous irritation can be a major problem. This can be mitigated with shorter infusion times of 5 to 10 minutes,” explained the author of the study “Navelbine: How I Use It,” which was published at the official journal of the Society for Translational Oncology, The Oncologist.

Vinorelbine to Treat Prostate Cancer

Vinorelbine was first approved by the US Food and Drug Administration (FDA) for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) in 2003. However, it has been used for the treatment of other conditions as well, including hormone-refractory prostate cancer. Commercialized under the brand name Navelbine by Teva Pharmaceuticals, the drug is available in the form of an injection to be intravenously administered. Each vial contains vinorelbine tartrate equivalent to 10 mg (1-mL vial) or 50 mg (5-mL vial) vinorelbine in Water for Injection. The dosage and number of cycles depend on the patient’s age, height, weight and additional diseases, as well as body’s response to the treatment.

“Prostate cancer is a common disease in older men. Since it is hormone resistant, no treatment may improve survival. In patients with hormone-refractory prostate cancer, clinical benefit is an important treatment end point,” stated the study “Vinorelbine and prednisone in older cancer patients with hormone-refractory metastatic prostate cancer. A phase II study,” which focused on the of vinorelbine in combination with prednisone for the treatment of patients with hormone-refractory prostate cancer. “The treatment was well tolerated and grade 3 toxicity was found in 2 cases of anemia and 2 cases of leukopenia without fever. The schedule is able to control the evolution of hormone-refractory prostate cancer and to give a clinical benefit. These results provide information for further clinical trials in a large series of elderly cancer patients.”

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