Vinflunine in the treatment of relapsed metastatic urothelial cancer: A systematic review and meta-analysis of real-world series. (August 2019)

• Record Type: Journal Article
• Authors: Bamias, Aristotelis; Hegele, Axel; Medioni, Jacques; Castellano, Daniel; Doni, Laura; Passalacqua, Rodolfo; Zagouri, Flora; Tzannis, Kimon; Hussain, Syed; Ullen, Anders
• Is Part Of: Critical reviews in oncology/hematology. Volume 140(2019)
• Page Start: 80
• Page End: 87
• Publication Date: 2019-08
• Subjects: Urothelial cancer -- Vinflunine -- Meta-analysis -- Second-line -- Metastatic; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2019.05.006
• Languages: English
• ISSNs: 1040-8428

Abstract

Graphical abstract: Highlights: Real-world data confirm activity and safety of vinflunine within its approved use. Immunotherapy is a new standard for relapsed advanced urothelial cancer. Immunotherapy offers long-term responses to only 25% of patients. Vinflunine represents a useful option in patients not responding to immunotherapy. Abstract: Background: Vinflunine (VFL) is approved in Europe as second-line treatment of metastatic urothelial cancer after failure of platinum-containing therapy. We performed a systematic review and meta-analysis of real-world data (RWD) to assess utilization, efficacy and safety of VFL. Methods: We performed a MEDLINE search for the period of 1/1/2000-31/8/2017. Full-length articles providing post-marketing RWD on VFL in patients failing previous chemotherapy were eligible. Interventional clinical trials were excluded. Results: Ten studies with 797 patients were identified. According to pooled REs analysis, overall response rate was 19%, most frequent, all-grade toxicities were fatigue (41%), constipation (39%), nausea/vomiting (25%), and most prevalent Grade 3–4 toxicities were neutropenia (13%), anaemia (9%), fatigue (8%). Median OS was comparable to results reported in recent randomized studies. Conclusion: Our findings confirm the efficacy and safety of VFL in an unselected population and support the use of VFL in the changing treatment paradigm of relapsed mUC.