Role of vindesine in induction chemotherapy in locally-advanced non-small-cell lung cancer

Locally advanced non-small-cell lung cancer (NSCLC) in most cases is not curable at the present time. Owing to the local extent of the tumor, the rate of complete resections is low and, therefore, survival in these patients is poor. For this reason, induction chemotherapy is being investigated in patients expected to have a poor prognosis after standard surgery and radiotherapy. The rationale for induction chemotherapy is to increase the rate of complete resections and achieve early elimination of micrometastases. Clinical investigations have reported an improvement of survival in stage III NSCLC after induction chemotherapy by using different combinations of cytotoxic drugs. Vindesine ranks among the most active single agents in this disease and has been part of a number of combination regimens in induction chemotherapy. The combination of mitomycin, vindesine or vinblastine and cisplatin has produced encouraging results in several studies, indicating a possible improvement of survival in stage III NSCLC, although its superiority to other combinations yet has to be demonstrated.