Vinblastine
| Evidence Level: L4 | Predicted Indications: 10 |
Table of Contents
Vinblastine: Rhabdomyosarcoma (disease)
One-Sentence Summary
Vinblastine is a vinca alkaloid that blocks cell division by binding tubulin. The TxGNN model predicts it may be effective for rhabdomyosarcoma, with an evidence level of L4. There are currently no registered clinical trials, and the literature consists mainly of case reports of vinblastine-containing combination chemotherapy, plus preclinical work.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Rhabdomyosarcoma (disease) |
| TxGNN Prediction Score | 0.9986 |
| Evidence Level | L4 |
| India Market Status | Listed in a compiled Indian medicine price dataset (4 of 4) – CDSCO approval status is not included in this data |
| Number of Listed Products | 4 (valid: 4) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Vinblastine binds tubulin, the protein building block of microtubules, and disrupts microtubule dynamics. This causes mitotic arrest in rapidly dividing cells, which is a plausible antitumour mechanism in rhabdomyosarcoma, a fast-growing soft tissue tumour. Detailed mechanism-of-action data are not otherwise available in the data compiled for this report.
Supporting evidence is limited. A case report describes a partial response in an adult with perianal rhabdomyosarcoma after a regimen of nivolumab, dacarbazine, cisplatin and vinblastine. Another older case report describes a child with refractory prostatic rhabdomyosarcoma whose pelvic mass shrank rapidly on cisplatin, vinblastine and peplomycin. In both, vinblastine was given with other agents, so its own contribution cannot be separated out.
Preclinical work adds some mechanistic context: a study in rhabdomyosarcoma models found synthetic lethality between PLK1 inhibitors and microtubule-destabilising drugs, and xenograft work examined the selectivity of vinca alkaloids in human rhabdomyosarcoma.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 38050209 | 2023 | Case report/Review | Medicine | Adult perianal rhabdomyosarcoma; partial response after nivolumab, dacarbazine, cisplatin and vinblastine, followed by surgery |
| 2451411 | 1987 | Case report/Review | Hinyokika Kiyo | Refractory prostatic rhabdomyosarcoma in a child; rapid shrinkage of the pelvic mass with cisplatin, vinblastine and peplomycin |
| 22156656 | 2011 | Pilot study | Oncotarget | Pilot of a pediatric metronomic 4-drug regimen in resistant cancers |
| 3329524 | 1987 | Preclinical | Anti-Cancer Drug Design | Human rhabdomyosarcoma xenografts in mice used to study the therapeutic selectivity of vinca alkaloids |
| 26024389 | 2015 | Preclinical | Cell Death and Differentiation | Synthetic lethality of PLK1 inhibitors with microtubule-destabilising drugs in rhabdomyosarcoma models |
| 41216926 | 2026 | Cohort | Pediatric Blood & Cancer | Trials in non-rhabdomyosarcoma soft tissue sarcoma in children; limited relevance |
| 14328283 | 1965 | Historical review | British Journal of Clinical Practice | Historical overview of tumour chemotherapy in children |
India Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 106054 | Hoydetain 1mg Injection | Vial of 10 ml powder for injection | Not specified in the licence record |
| 230727 | Uniblastin 10mg Injection | Vial of 10 ml injection | Not specified in the licence record |
| 118945 | Kristina V 1mg Injection | Vial of 1 injection | Not specified in the licence record |
| 236396 | Vblastin 10mg Injection | Vial of 10 ml injection | Not specified in the licence record |
All four registrations are valid single-ingredient injectable products.
Cytotoxicity
| Item | Content |
|---|---|
| Cytotoxicity Classification | Conventional cytotoxic (vinca alkaloid, antimitotic) |
| Myelosuppression Risk | High (neutropenia and thrombocytopenia are recognised concerns) |
| Emetogenicity Classification | Please refer to the package insert warnings and precautions |
| Monitoring Items | CBC with differential, liver function, signs of peripheral neuropathy |
| Handling Protection | Must follow cytotoxic drug handling regulations; injectable vesicant, intravenous use only |
Safety Considerations
- Drug Interactions: 371 interactions were found in total. Notable examples include the major interaction with clarithromycin, and moderate interactions with aprepitant, dexamethasone, metronidazole, miconazole, rolapitant, rosuvastatin, simvastatin and tinidazole.
- Conditions of concern (recorded as contraindication relationships, not label text): liver failure, thrombocytopenia, neutropenia, agranulocytosis, peripheral neuropathy, hyperbilirubinemia, Gilbert syndrome, lung disease, myocardial ischemia and coronary artery disease, and infectious disease.
Package insert warnings and contraindications for the Indian products are not available in the data compiled for this report. Please refer to the package insert for full safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The evidence level is L4: the support for rhabdomyosarcoma consists only of case reports of vinblastine-containing combination chemotherapy and preclinical studies. No clinical trials are registered, and vinblastine’s own contribution cannot be separated from co-administered drugs.
To proceed, the following is needed:
- Prospective clinical data, or a registered trial, evaluating vinblastine in rhabdomyosarcoma
- Review of vinblastine’s role within modern standard-of-care rhabdomyosarcoma regimens
- Package insert warnings and contraindications for the Indian products
- Detailed mechanism-of-action data
- A safety monitoring plan covering myelosuppression, neurotoxicity and the major drug interactions
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.