A large body of preclinical and clinical data concerning the new semisynthetic vinca alkaloid vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Médicament, Paris, France) are now available. At both the cellular and clinical levels, this drug shows reduced neurotoxicity compared with other vinca alkaloids. In phase III clinical trials of patients with advanced non-small cell lung cancer (NSCLC), treatment with the combination of vinorelbine and cisplatin resulted in survival advantages greater than those achieved by vindesine plus cisplatin. The median survival durations of patients receiving single-agent vinorelbine were comparable with those of patients treated with vindesine plus cisplatin, and greater than those of patients treated with 5-fluorouracil and leucovorin. The dose-limiting toxicity of vinorelbine, granulocytopenia, was transient and seldom resulted in hospitalization. Treatment with vinorelbine did not result in negative effects on patient quality of life. Vinorelbine is now being actively investigated in combination and multimodality regimens in patients with various stages of NSCLC. New strategies to avoid vinorelbine-related granulocytopenia are also being developed. Vinorelbine-containing regimens hold the promise of providing effective, well-tolerated treatment for patients with NSCLC.