A Comprehensive Monograph on Vindesine (DB00309): From Botanical Origins to Clinical Application and Market Realities

Executive Summary

Vindesine is a second-generation, semisynthetic vinca alkaloid, a potent antineoplastic agent derived from the natural product vinblastine. As a member of the antimicrotubule class of chemotherapeutics, its primary mechanism of action involves the inhibition of tubulin polymerization, which disrupts the formation of the mitotic spindle, leading to cell cycle arrest in metaphase and subsequent apoptosis. This report provides a comprehensive examination of Vindesine, identified by DrugBank ID DB00309 and CAS Number 53643-48-4, synthesizing data from its botanical origins to its current clinical and regulatory standing.

Clinically, Vindesine established a crucial niche in the treatment of various malignancies, most notably as a salvage therapy for acute lymphoblastic leukemia (ALL) in pediatric patients who have developed resistance to the first-generation vinca alkaloid, vincristine. Its activity also extends to lymphomas, melanoma, breast cancer, and lung cancer, typically as a component of combination chemotherapy regimens. The pharmacological profile of Vindesine is distinguished by its high potency and a lack of complete cross-resistance with vincristine, underpinning its value in second-line treatment protocols. However, its therapeutic utility is balanced by significant dose-limiting toxicities, primarily myelosuppression (specifically granulocytopenia) and peripheral neurotoxicity, which require careful clinical management and dose adjustment.