P0153 Toxicity of vinorelbine with platinum as adjuvant chemotherapy for non-small-cell lung cancer: A single institution experience

Abstract

<h3>Background</h3> Vinorelbine with platinum is a standard adjuvant treatment for patients with resectable non-small-cell lung cancer (NSCLC). The pivotal phase 3 studies using a weekly intravenous vinorelbine schedule report high levels of toxicity. In our centre we use vinorelbine on a day 1 and 8 schedule to reduce the incidence of neutropenia. We audited our adjuvant use of vinorelbine with platinum to assess toxicity. <h3>Methods</h3> We did a retrospective case note review of all patients receiving vinorelbine with either cisplatin or carboplatin between 2008 and 2013. <h3>Findings</h3> Thirty-one patients received either cisplatin 80mg/m² day 1 with vinorelbine intravenously 30mg/m² on day 1 and 8 or carboplatin AUC5 with vinorelbine intravenously 25mg/m² on day 1 and day 8 for a maximum of four cycles. Choice of platinum was based on the patient's renal function. Chemotherapy toxicity was generally manageable. Two patients discontinued treatment early due to toxicity, both after cycle 2 and dose adjustment was used to continue treatment in others. Fifteen patients (45%) experienced grade 2/3 neutropenia; there were two cases of grade 3 mucostitis, two cases of grade 3 fatigue and three cases of gastrointestinal toxicity (paralytic ileus). In addition, seven patients (21%) developed grade 3 thrombophlebitis and were switched to the oral formulation of vinorelbine to complete treatment. <h3>Interpretation</h3> Vinorelbine with platinum as adjuvant chemotherapy for NSCLC had manageable toxicity. Only two patients had to discontinue treatment due to toxicity. However, over a fifth of patients experienced serious intravenous complications and were switched to oral vinorelbine to complete treatment. We recommend using the oral formulation in this setting, which will help ease capacity constraints and is more comfortable for the patient.