Monoinstitutional real world experience in management of Vinflunine as second line therapy for transitional cell carcinoma of the urothelium

// Giovanni Schinzari 1 , Ernesto Rossi 1 , Francesco Pierconti 2 , Giovanna Garufi 1 , Santa Monterisi 1 , Antonia Strippoli 1 , Ettore D’Argento 1 , Alessandra Cassano 1 and Carlo Barone 1 1 Department of Medical Oncology, Universita Cattolica del Sacro Cuore, Rome, Italy 2 Department of Pathology, Universita Cattolica del Sacro Cuore, Rome, Italy Correspondence to: Giovanni Schinzari, email: giovanni.schinzari@unicatt.it Keywords: vinflunine; transitional cell carcinoma of the urothelium; second line; toxicity Received: July 18, 2017      Accepted: December 03, 2017      Published: January 11, 2018 ABSTRACT Vinflunine is the only cytotoxic agent tested as a second line therapy in transitional cell carcinoma of the urothelium in a phase III trial. It is not largely employed in clinical practice because of the high incidence of grade 3–4 toxicity. We evaluated efficacy and safety of Vinflunine at the dose of 280 mg/m 2 every 3 weeks associated with primary prophylaxis with granulocyte growth factors and laxatives for patients progressed after platinum + Gemcitabine. Overall survival was 8.5 months, progression-free survival 4.33 months and response rate 25%, with disease control rate 57.2%. Grade III-IV neutropenia occurred in 10.7% of the patients, grade III-IV anemia and grade III thrombocytopenia in 10.7% and 7.2%, respectively. Among non haematological toxicity, grade I-II constipation was reported in 14.2% of the patients, without grade III-IV adverse events. No discontinuation for toxicity was observed. This study underlines that Vinfluinine at a dose of 280 mg/m 2 associated with primary prophylaxis for neutropenia and constipation is effective and with a favorable toxicity profile.