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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › ANTINEOPLASTIC AGENTS › PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS › Vinca alkaloids and analogues
vinflunine
L01CA05
Forms & Strengths
- Intravenous solution: 25 mg/mL, 250 mg/25 mL, 500 mg/50 mL
Adult Dosing
- 320 mg/m² administered as a 20-minute intravenous infusion every 3 weeks
- Dose reduction to 280 mg/m² in patients with mild hepatic impairment or prior pelvic radiotherapy
- Dose reduction to 250 mg/m² in patients with moderate hepatic impairment
- Renal adjustment required for CrCl < 40 mL/min
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Monotherapy for advanced or metastatic transitional cell carcinoma of the urothelial tract after failure of a platinum-containing regimen
Mechanism of Action
- Vinca alkaloid that inhibits tubulin polymerization, binding primarily to the high-affinity sites on tubulin, inducing mitotic arrest in G2/M phase and leading to cell apoptosis
Contraindications
- Hypersensitivity to vinflunine or other vinca alkaloids
- Baseline neutrophil count < 1,500/mm³
- Severe hepatic impairment (Child-Pugh C)
- Severe ongoing infection
- Breastfeeding
Adverse Reactions
- Neutropenia and leukopenia
- Anemia and thrombocytopenia
- Constipation and abdominal pain
- Fatigue and asthenia
- Peripheral neuropathy
- Nausea, vomiting, and stomatitis
- Alopecia
- QT interval prolongation
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) may increase vinflunine toxicity
- Strong CYP3A4 inducers (e.g., rifampin, carbamazepine) may decrease vinflunine efficacy
- P-glycoprotein inhibitors may alter plasma concentrations of vinflunine
- Concomitant use with other QT-prolonging drugs increases the risk of ventricular arrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use