Vinflunine

Description

Vinflunine (also referred to as PM391) is a semisynthetic analog of the natural vinca alkaloids vinblastine and vincristine that was approved by the European Medicines Agency (EMEA) in 2009 for the treatment of adult patients with advanced or metastatic transitional cell carcinoma of the urothelial tract after failure of a prior platinum-containing regimen. Vinflunine is synthesized from anhydrovinblastine in a superacid media (HF-SbF₅) and in the presence of a chlorinated solvent like CHCl₃ or CCl₄.

Originator

Pierre Fabre (France)

Definition

ChEBI: An organic heteropentacyclic compound and an organic heterotetracyclic compound that is vinorelbine in which the tetrahydropyridine moiety of the heterotetracyclic part of the molecule has been redced to the corresponding piperidine, and in which the ethy group attached to this ring has been replaced by a 1,1-difluoroethyl group.

brand name

Javlor

Clinical Use

Antineoplastic agent (vinca alkaloid):
Treatment of advanced or metastatic bladder cancer

Drug interactions

Potentially hazardous interactions with other drugs
Antibacterials: possible increased risk of ventricular arrhythmias with delamanid; concentration possibly reduced by rifampicin - avoid.
Antidepressants: concentration possibly reduced by St Johns wort - avoid.
Antifungals: concentration increased by ketoconazole and possibly itraconazole (increased risk of neurotoxicity) - avoid.
Antimalarials: avoid with piperaquine with artenimol.
Antipsychotics: avoid with clozapine (increased risk of agranulocytosis).
Antivirals: concentration possibly increased by ritonavir - avoid.
Grapefruit juice: concentration of vinflunine increased - avoid.

Metabolism

Metabolised by the cytochrome CYP3A4 isoenzyme, except for 4-O-deacetylvinflunine (DVFL), the only active metabolite and main metabolite in blood which is formed by multiple esterases. Excretion occurs via the faeces (about two-thirds) and the urine (about one-third).