Phase II Trial of Oral Vinorelbine in Children With Recurrent or Progressive Unresectable Low-Grade Glioma

Inclusion Criteria: TUMOR CHARACTERISTICS: * Histologically confirmed recurrent or progressive primary Low-Grade Glioma (LGG) defined as follow (WHO classification 2007): optic pathway glioma (OPG), pilocytic astrocytoma (PA), fibrillary or diffuse astrocytoma (DA), oligodendroglioma (OG) or oligoastrocytoma (OA) * Patients with OPG do not require biopsy confirmation of disease, if clinical and radiological findings as well as ophthalmological examination are unequivocal * Low-Grade Glioma involving the brainstem can be included in case of histological confirmation * Tumor has to be considered as non totally resectable PATIENT CHARACTERISTICS: * Age 6-18 years old * Lansky or Karnofsky status more than 50 % * Measurable disease on cerebral and/or spinal MRI, with at least 1 lesion diameter superior to 1 cm * Patients with metastatic disease are eligible, but at least 1 lesion must be measurable as previously defined * Patients must have received at least 1 prior chemotherapy regimen containing carboplatin * Life expectancy of at least 3 months * Evidence of adequate organ functions, including: * neutrophil count (ANC) ≥ 1500/mm3 , * platelet count ≥100 000/mm3 ; * serum creatinine \< 1.5 x normal for age when the serum creatinine is ≥ 1.5 × the ULN, the glomerular filtration rate (either estimated or formal) must be \> 70 mL/min/1.73m2; * total bilirubin\< 1.5 x normal for age, * ASAT and ALAT \< 2.5 x normal for age * Effective contraception for patients (male and female) with reproductive potential, and for a minimum of 3 months after the end of treatment * Negative pregnancy test, if applicable * Patients able to swallow capsules * Patient affiliated with a health insurance system * Written informed consent of patient and/or parents/guardians prior to the study participation. PRIOR OR CONCURRENT THERAPY * Prior treatments containing vinca alkaloids like vincristine and/or vinblastine are authorized * Patients must have fully recovered from the toxic effects of any prior therapy before entering the study. No organ toxicity superior to grade 2 according to NCI-CTCAE v4.0 * An interval of at least 2 months from prior radiotherapy, 6 weeks from nitrosourea chemotherapy, and 4 weeks from other chemotherapy regimen, is required Exclusion Criteria: * Inclusion criteria failure * Prior treatment with intravenous or oral vinorelbine * Known hypersensibility to other vinca-alkaloïdes * Digestive pathology affecting absorption in a important way * Prior surgical resection of stomach or the small intestine * Severe hepatic failure independent from tumoral disease * Fructose intolerance * Leptomeningeal relapse without any available measurable disease on MRI (for example, leptomeningeal relapse with totally resected primary lesion) * Uncontrolled active infection within 2 weeks * Pregnancy or breast feeding woman * Uncontrolled intercurrent illness or active infection * Unsuitable for medical follow-up (geographic, social or mental reasons) * Patients requiring long-term oxygen therapy * Patients with ANC less than 1500/mm3 * Patients vaccinated against yellow fever