The Pharmaceutical Journal
Vol 269 No 7229 p879
21/28 December 2002

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National Institute for Clinical Excellence (www.nice.org.uk)

Vinorelbine not recommended as first-line treatment in advanced breast cancer

Vinorelbine (Navelbine) should not be used as first-line treatment for advanced breast cancer, according to the National Institute for Clinical Excellence.

In its guidance issued earlier this week, NICE says that there is insufficient evidence to suggest that first-line monotherapy with vinorelbine has advantages over other treatments, either in terms of clinical benefit or cost-effectiveness. However, it says that after failure of anthracycline-based first-line therapy, or if anthracycline therapy is unsuitable, vinorelbine monotherapy is a potentially useful choice because of its low toxicity. A choice of follow-up treatment should be made by the patient and clinician after a discussion of the relative benefits of available drugs and their side effect profiles.

NICE adds that after looking at the available evidence it cannot recommend routine use of the drug in combination with other chemotherapy agents. However, the guidance outlines further research required to investigate the effectiveness of combination therapy.

Copies of the guidance are available on the NICE website (www.nice.org.uk) and can also be obtained from the NHS response line, 0870 1555 455, quoting reference number N0142.