Leucovorin Calcium and Vinorelbine Tartrate

• Generic Name: leucovorin
• Dosage Forms: n.a.
• Other Brand Names: Wellcovorin

Antidote for unintentional overdosage of methotrexate (e.g., resulting from impaired elimination) and other folic acid antagonists (e.g., pyrimethamine, trimethoprim).

IV rescue therapy after high-dose methotrexate regimen (to control duration of exposure of sensitive cells to methotrexate) in the treatment of osteosarcoma (designated an orphan drug by FDA for this use).

Prevention of hematologic toxicity associated with pyrimethamine, trimethoprim, or trimetrexate therapy.

IV treatment of folate deficient megaloblastic anemias (e.g., serum folate concentration <0.002 mcg/mL) of infancy, pregnancy, sprue, and nutritional deficiencies when oral folic acid therapy is not feasible. No advantage over folic acid injection since ability to convert folic acid to tetrahydrofolic acid (THF) is not impaired in these anemias.

Effective in the treatment of megaloblastic anemia resulting from congenital dihydrofolate reductase deficiency.

Not effective in the treatment of pernicious anemia and other megaloblastic anemias secondary to lack of vitamin B12; avoid such use. (See Contraindications under Cautions.)

Adjunct to fluorouracil to prolong survival in the palliative treatment of advanced colorectal cancer (designated an orphan drug by FDA for this use).

First-line therapy for management of advanced colorectal cancer in a combination regimen consisting of fluorouracil, leucovorin, and either irinotecan or oxaliplatin.

• Generic Name: vinorelbine
• Dosage Forms: n.a.
• Other Brand Names: Navelbine

Used alone or in combination with cisplatin as first-line therapy in ambulatory patients for the palliative treatment of unresectable, advanced non-small cell lung cancer (NSCLC).

Used alone or in combination with cisplatin in patients with Stage IV NSCLC.

Use in combination with cisplatin is preferred treatment of advanced NSCLC in patients with good performance status because of improved response and survival.

Used in combination with cisplatin in patients with Stage III NSCLC.

Use in combination with cisplatin is being investigated for adjuvant treatment of completely resected NSCLC.

Use in combination with trastuzumab is being investigated for the treatment of HER2-overexpressing metastatic breast cancer.

Has been used as first-line or salvage therapy for metastatic breast cancer in combination with various other agents, including anthracyclines (e.g., doxorubicin), fluoropyrimidines (e.g., fluorouracil, capecitabine), mitoxantrone, cisplatin, taxanes (e.g., docetaxel, paclitaxel), ifosfamide, or gemcitabine.

Has been used as monotherapy in first-line or salvage (e.g., second-line or subsequent) treatment of metastatic breast cancer.

Use in the treatment of metastatic or recurrent cervical cancer is being investigated.

Use in combination with other antineoplastic agents (e.g., cisplatin) is being evaluated in patients with metastatic or recurrent cervical cancer.

Has been used in the treatment of adult soft tissue sarcomas.

Has been used in the treatment of esophageal cancer.