Efficacy and safety of Vinflunine for advanced or metastatic urothelial carcinoma in routine practice based on the French multi-centre CURVE study

To retrospectively assess the efficacy and safety of Vinflunine (VFL) under routine conditions and identify overall survival (OS) prognostic factors. Twenty centres participated in the retrospective study (minimum 4 patients undergoing VFL treatment for advanced/metastatic UC after platinum-based regimen progression. Primary endpoint was OS. Secondary endpoints: progression-free survival (PFS), radiological response rate (RR) RECIST criteria and toxicity (CTC NCI v3). These centres enrolled 134 patients. Prior chemotherapy (CT) lines (≥1 palliative): 1 and ≥2 in 69 % and 26 % of patients, respectively. Performance status (PS): 0, 1, 2 in 25 %, 46 % and 23 % of patients. Median OS = 8.2 months [6.5–9.4], PFS = 4.2 months and RR 22 %, median number of 5 cycles. In risk groups based on 0–3 presence of adverse prognostic factors (PS ≥1, haemoglobin ≤10 g/dl and liver metastasis), median OS: 13.2, 9.9, 3.6, and 2.4 months (P < .0001), respectively; 3.3 months (1.9–5.6) in PS ≥ 2 subgroup. This study reflects routine UC management and confirmed VFL patient efficacy. The drug is safe with gastro-intestinal and haematological prophylaxis. Analysis of prognostic factors for OS is consistent with pivotal trials