Vinblastine for Low-Grade Glioma Has Few Side Effects and Comparable Survival

Vinblastine monotherapy has similar outcomes and a more favorable toxicity profile compared with current therapies when used in patients with treatment naïve pediatric low-grade glioma (PLGG), according to a study published in the Journal of Clinical Oncology.

The study, led by Eric Bouffet, MD, The Hospital for Sick Children (Toronto, Ontario, Canada), enrolled 54 patients under the age of 18 years with unresectable or progressive therapy-naïve PLGG. Vinblastine was administered once per week intravenously over a period of 70 weeks. Along with overall and progression-free survival, researchers also looked how patients’ vision, quality of life, neurofibromatosis type 1 (NF1) status, and BRAF mutation status correlated with survival.

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Overall, the response rate to vinblastine was 25.9% and 87% of patients achieved disease stabilization. Visual Impairment also improved in 20% of patients with optic pathway glioma.

The 5-year overall and progression free survival rates were 94.4% and 53.2% respectively. Further, 24.1% of patients had NF1 and, although these patients were younger at diagnosis compared with those who did not have NF1, they experienced significantly improved progression-free survival (85.1% vs 42%). There was no correlation between BRAF alterations and survival.

Additionally, Adverse events were mild and no patient had to discontinue treatment as a result of toxicity. Some patients did have to have their planned dose reduced, but there was no observed relationship between dose reduction and survival. Quality of life was not affected during treatment.

The most frequent adverse events were neutropenia (75.9%), upper respiratory tract infection (52%), and fever (43%). About 40% of patients experienced grade 3 neutropenia and about 35% experienced grade 4 neutropenia.

From these results, researchers concluded that vinblastine monotherapy for pediatric patients with treatment naïve low-grade glioma is well tolerated and leads to similar outcomes compared with those observed with other conventional therapies.