vincristine

Overview

Vinca alkaloid microtubule inhibitor; the “O” (Oncovin) in CHOP.

Evidence in the corpus

  • Component of CHOP/CHOEP/EPOCH/BV-CH(E)P regimens in 132 MSK nodal PTCL patients; TP53 mutation identified patients with inferior PFS (HR 3.1, P=.005) on vincristine-containing induction PMID:37078708.
  • Included as part of NCCN-recommended recurrent top-five regimens for RMS (alongside cyclophosphamide and doxorubicin) in the UCLA PDTO sarcoma functional screen actionability mapping. PMID:39305899
  • Component of ISG/SSG IV protocol (vincristine, doxorubicin, ifosfamide, etoposide) for EWSR1::BEND2 urinary-bladder sarcoma; intravesical disease cleared but pelvic and lung metastases did not respond; regimen reflects ESMO-recommended Ewing-like chemotherapy approach for EWSR1-non-ETS fusion sarcomas PMID:28199314.
  • Component of PCV (procarbazine/lomustine/vincristine) induction regimen used as the historical comparator arm in a phase II trial (NCT00588523) for 1p/19q-codeleted anaplastic oligodendroglioma (ODG3); in an exploratory cross-trial comparison, single-agent TMZ induction was non-inferior to PCV induction with the same HDC-ASCT backbone (HR 3.38 favoring TMZ for OS, P=0.005). PMID:28472509

Resistance mechanisms

  • TP53 mutations and 17p deletions associate with inferior PFS on CHOP-based induction PMID:37078708.

Cancer types (linked)

  • PTCL, AITL, ALCL, RMS
  • ODG3 — component of PCV induction comparator arm in 1p/19q-codeleted anaplastic oligodendroglioma HDC-ASCT trial.

Sources

  • PMID:37078708

  • PMID:39305899 — Duminuco et al. 2024, UCLA PDTO sarcoma screen; NCCN-recommended RMS regimen.

  • PMID:28199314

  • PMID:28472509 — Thomas et al. 2017, J Clin Oncol. Phase II NCT00588523; vincristine as V in PCV induction comparator arm for 1p/19q-codeleted anaplastic oligodendroglioma; TMZ found non-inferior.

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