CHO RAY CANCER CENTER

ORAL VINORELBINE:

CLINICAL EXPERIENCE IN mNSCLC

NGUYEN NGOC BAO HOANG. MD. PHD

 DISCLOSURE

I have no actual or

potential conflict of interest in

relation to this presentation !

 DIAGNOSIS
• F / 77Y
• L Lung cancer,
• Adenoma Carcinoma,
TREATMENT OUTCOME
22//01/18 • CT: mediastinal lymph nodes,
ERLOTINIB PR
multifocal lung metastases
• EGFR(+), ALK (-), PD-L1 (-)
• ECOG: 01

DIAGNOSIS
• Bone Scan: multifocal bone
metastases
• CT: pleural effuion, mediastinal lymph
23/03/19
nodes, multifocal lung metastases
• Progression
• EGFR(-), ALK (-), PD-L1 (-)
• ECOG: 03
ECOG: 02 or ELDERLY

WHAT CAN WE DO ?
 ECOG 5592: Elderly Data
• RANDOMIZATION cDDP 75 mg/m2 &
– Etoposide 100 mg/m2 d 1-3
– Paclitaxel 135 mg/m2/24o d 2
– Paclitaxel 250 mg/m2/24o d 2 + G-CSF

Langer et al., J Natl Cancer Inst. 94(3): 173-181, 2002

 COMBINATION CHEMOTHERAPY ?
An Analysis of Southwest Oncology Trials
9509 and 9308

SWOG 9509 SWOG 9308

Paclitaxel + Carboplatin Vinorelbine + Cisplatin
versus versus
Vinorelbine + Cisplatin Cisplatin
 COMBINATION CHEMOTHERAPY ?
An Analysis of Southwest Oncology Trials
9509 and 9308
GEMCITABINE + VINORELBINE ?
 DIAGNOSIS
• F / 77Y
• L Lung cancer,
• Adenoma Carcinoma,
TREATMENT OUTCOME
22//01/18 • CT: mediastinal lymph nodes,
ERLOTINIB PR
multifocal lung metastases
• EGFR(+), ALK (-), PD-L1 (-)
• ECOG: 01

DIAGNOSIS
• Bone Scan: multifocal bone
metastases
• CT: pleural effuion, mediastinal lymph TREATMENT
23/03/19
nodes, multifocal lung metastases ORAL VINORELBINE
• Progression
• EGFR(-), ALK (-), PD-L1 (-)
• ECOG: 03
RESULTS
RESULTS
 DIAGNOSIS
• F / 77Y
• L Lung cancer,
• Adenoma Carcinoma,
TREATMENT OUTCOME
22//01/18 • CT: mediastinal lymph nodes,
ERLOTINIB PR
multifocal lung metastases
• EGFR(+), ALK (-), PD-L1 (-)
• ECOG: 01

DIAGNOSIS
• Bone Scan: multifocal bone
metastases
• CT: pleural effuion, mediastinal lymph TREATMENT
23/03/19 OUTCOME
nodes, multifocal lung metastases ORAL VINORELBINE CR
• Progression
• EGFR(-), ALK (-), PD-L1 (-)
• ECOG: 03
PROGRESSION AFTER MULTI REGIMENS

WHAT CAN WE DO ?
 DIAGNOSIS
• F / 27Y
• L Lung cancer, TREATMENT
• Adenoma Carcinoma, • 1L: PEME- CIS
OUTCOME
20//05/18 • CT: mediastinal lymph nodes, pleural • 2L: PAC-CAR-BEVA
SD
metastases • 3L: DOCE-BEVA
• EGFR(-), ALK (-), PD-L1 (-) • Maintain: DOCE
• ECOG: 01

DIAGNOSIS

• CT: pleural effuion, mediastinal lymph

nodes, multifocal lung metastases

26/03/19
• Progression

• EGFR(-), ALK (-), PD-L1 (-)

• ECOG: 01
 DIAGNOSIS
• F / 27Y
• L Lung cancer, TREATMENT
• Adenoma Carcinoma, • 1L: PEME- CIS
OUTCOME
20//05/18 • CT: mediastinal lymph nodes, pleural • 2L: PAC-CAR-BEVA
SD
metastases • 3L: DOCE-BEVA
• EGFR(-), ALK (-), PD-L1 (-) • Maintain: DOCE
• ECOG: 01

DIAGNOSIS

• CT: pleural effuion, mediastinal lymph

nodes, multifocal lung metastases TREATMENT

26/03/19
• Progression ORAL VINORELBINE

• EGFR(-), ALK (-), PD-L1 (-)

• ECOG: 01
WHY CHOOSE THIS DRUG ?
RESULTS
 DIAGNOSIS
• F / 27Y
• L Lung cancer, TREATMENT
• Adenoma Carcinoma, • 1L: PEME- CIS
OUTCOME
20//05/18 • CT: mediastinal lymph nodes, pleural • 2L: PAC-CAR-BEVA
SD
metastases • 3L: DOCE-BEVA
• EGFR(-), ALK (-), PD-L1 (-) • Maintain: DOCE
• ECOG: 01

DIAGNOSIS

• CT: pleural effuion, mediastinal lymph

nodes, multifocal lung metastases TREATMENT

26/03/19 OUTCOME
• Progression ORAL VINORELBINE PR
• EGFR(-), ALK (-), PD-L1 (-)

• ECOG: 01