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Vinflunine as second-line treatment in platin-resistant metastatic urothelial carcinoma: a review

Gerullis, Holgera,b,c; Ecke, Thorstend; Eimer, Christopha,c; Wishahi, Mohamede; Otto, Thomasa,b,c

doi: 10.1097/CAD.0b013e3283404db0

The novel third-generation bifluorinated semisynthetic vinca alkaloid, vinflunine, is a microtubule inhibitor that shows superior antitumor activity and a favorable safety profile compared with other vinca alkaloids. The main antineoplastic effects of vinflunine arise from its interaction with tubulin, the major component of microtubules in mitotic spindles. Vinflunine is known to have low affinity for tubulin, high intracellular accumulation, and important effects on microtubule dynamics. It has been shown to have activity against transitional cell carcinoma of the urothelial tract. Vinflunine was investigated in a randomized phase III clinical trial comparing vinflunine and best supportive care versus best supportive care alone in patients with advanced transitional cell carcinoma of the urothelial tract, who were progressive after first-line platinum-containing therapy. At an acceptable safety profile without cumulative toxicity, second-line treatment with vinflunine has shown a survival advantage and has therefore been approved in 2009 for this indication. This review gives a brief outline on vinflunine as a second-line treatment for platin-resistant advanced urothelial carcinoma; it describes pharmacology, efficacy studies, tolerance, and side effects and briefly discusses future clinical perspectives.

aDepartment of Urology, Lukas Hospital, Neuss

bWest German Cancer Center (WTZ), University of Essen, Essen

cGerman Centre for Assessment and Evaluation of Innovative Techniques in Medicine (DZITM)

dDepartment of Urology, HELIOS Hospital, Bad Saarow, Germany

eDepartment of Urology, Theodor Bilharz Research Institute, Cairo, Egypt

Correspondence to Dr Holger Gerullis, Department of Urology, Lukas Hospital, Neuss, Germany Tel: +49 2131 8882401; fax: +49 2131 8882499; e-mail:

Received July 24, 2010

© 2011 Lippincott Williams & Wilkins, Inc.