Vinorelbine tartrate

일반 설명Vinorelbine ditartrate is available in 1- and 5-mL vials at aconcentration of 10 mg/mL for IV use. It is FDA approvedfor the treatment of NSCLC. The agent has also been usedin treating metastatic breast cancer, cervical cancer, uterinecancer, and lung cancer especially in older patients or thosewith physical difficulties. Vinorelbine is the most lipophilicof the vinca alkaloids because of modifications of thecatharanthine ring system and dehydration of the piperidinering. This allows the agent to be quickly taken up into cellsincluding lung tissue where concentrations are 300-foldhigher than plasma concentrations. This is 3 to 13 timeshigher than the lung concentrations seen with vincristine.The agent is highly protein bound (80%–91%) and metabolizedby CYP3A. The major metabolite seen is the 4-Odesacetylderivative, which is equally active with the parentbut only formed in small quantities. The agent is eliminatedprimarily (33%–88%) in the bile with some appearing inthe urine (16%–30%). The elimination half-life is 27 to43 hours. The toxicities seen for vinorelbine includemyelosuppression, which is dose limiting but ceases upondiscontinuation of drug. This is most commonly seen as aneutropenia, and patient’s neutrophil count should be monitoredprior to and during therapy to decrease the chanceof infection. Additional toxicities include nausea/vomiting,elevation of liver function tests, alopecia, generalized fatigue，and inappropriate secretion of antidiuretic hormone.Neurotoxicity is seen with vinorelbine but occurs to a lesserdegree compared with other vinca alkaloids because of itsdecreased affinity for axonal microtubules.