Abstract
Urothelial cancer (UC) frequently affects male sex over the sixth decade of life, and in about 30% of the cases, it is diagnosed as muscle-invasive disease. For patients with metastatic disease, the prognosis is grim and the typical treatment is polychemotherapy involving cisplatin. Secondline chemotherapy is often employed, but a standard scheme does not exist. Vinflunine (VFL) is a new generation vinca alkaloid able to reversibly link the subunits of tubulin, causing the arrest of mitotic spindle polymerization. In critical trials, VFL has shown good activity and manageable toxicity; in a phase III randomized trial, it significantly improved survival compared with the best supportive care (BSC). VFL has received European Medicines Agency (EMA) approval for use as second-line treatment in UC patients who progressed after a first-line cisplatin-containing chemotherapy. Due to its low toxicity and promising efficacy, VFL is under clinical experimentations aimed to assess its role in other disease settings.
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