From the Guidelines
Vinblastine should be administered at a dosage of 0.11 mg/kg as part of the VIP regimen for testicular cancer, with cycles repeated every 3 weeks 1. This dosage is based on the most recent and highest quality study available, which provides guidelines for the treatment of testicular seminoma and non-seminoma. The VIP regimen, which includes vinblastine, ifosfamide, and cisplatin, is typically used as salvage chemotherapy for patients with intermediate or poor prognosis. Key considerations for vinblastine administration include:
- Dosage adjustments for patients with hepatic impairment
- Careful administration by qualified healthcare providers to avoid extravasation
- Regular monitoring of blood counts to manage myelosuppression
- Mechanism of action: binding to tubulin and inhibiting microtubule formation, disrupting cell division in rapidly dividing cancer cells. In contrast to other regimens, the VIP regimen with vinblastine at 0.11 mg/kg is specifically recommended for testicular cancer treatment, as outlined in the guidelines 1. While other studies may provide information on vinblastine dosing for different conditions, such as immune thrombocytopenia 1, the recommended dosage for testicular cancer is clearly outlined in the most recent guidelines 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: ... Adult Patients It is wise to initiate therapy for adults by administering a single intravenous dose of 3. 7 mg/m 2 of body surface area (bsa). A simplified and conservative incremental approach to dosage at weekly intervals for adults may be outlined as follows: First dose ....................................... 3.7 mg/m 2 bsa Second dose .................................. 5. 5 mg/m 2 bsa Third dose ...................................... 7.4 mg/m 2 bsa Fourth dose .................................. 9.25 mg/m 2 bsa Fifth dose ..................................... 11.1 mg/m 2 bsa The above-mentioned increases may be used until a maximum dose not exceeding 18. 5 mg/m 2 bsa for adults is reached.
The recommended dosage of vinblastine is 3.7 mg/m² of body surface area as an initial dose, with possible incremental increases to a maximum dose of 18.5 mg/m². The dose should be adjusted based on the patient's sensitivity to vinblastine, as indicated by white blood cell counts. For most adult patients, the weekly dosage will be 5.5 to 7.4 mg/m². 2
From the Research
Vinblastine Dosage
The recommended dosage of vinblastine varies depending on the specific treatment regimen and patient population.
- In a study of vinblastine in children with low-grade glioma, the dosage was 6 mg/m2 administered once per week intravenously over a period of 70 weeks 3.
- A phase I and pharmacological study of vinblastine by prolonged continuous infusion recommended a starting dose of 0.7 mg/m2/day, with dosage adjustments every 2 to 4 weeks based on the white blood cell count and steady-state serum vinblastine concentration 4.
- In a study of 5-day continuous-infusion vinblastine in the treatment of breast cancer, the dosage was 1.4 to 2.0 mg/m2/day 5.
- A study of high-dose cisplatin and vinblastine infusion with or without radiation therapy in patients with advanced non-small-cell lung cancer used a dosage of 7.5 mg/m2 as a continuous intravenous infusion over five days 6.
- In a phase II trial of vinblastine in advanced ovarian carcinoma, the dosage was 9 mg/m2 intravenously every three weeks until disease progression or toxicity supervened 7.
Dosage Considerations
When determining the dosage of vinblastine, several factors should be considered, including:
- The specific treatment regimen and patient population
- The potential for toxicity, such as leukopenia and peripheral neuropathy
- The need for dosage adjustments based on the white blood cell count and steady-state serum vinblastine concentration
- The potential for interactions with other medications or radiation therapy.