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Bun A, Nagahashi M, Kuroiwa M, Komatsu M, Miyoshi Y. Baseline interleukin-6 is a prognostic factor for patients with metastatic breast cancer treated with eribulin. Breast Cancer Res Treat 2023; 202:575-583. [PMID: 37733188 PMCID: PMC10564839 DOI: 10.1007/s10549-023-07086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/10/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Eribulin is a unique anti-cancer drug which can improve overall survival (OS) of patients with metastatic breast cancer (MBC), probably by modulating the tumor immune microenvironment. The aim of this study was to investigate the clinical significance of serum levels of immune-related and inflammatory cytokines in patients treated with eribulin. Furthermore, we investigated the association between cytokines and immune cells, such as myeloid-derived suppressor cells (MDSCs) and cytotoxic and regulatory T cells, to explore how these cytokines might affect the immune microenvironment. METHODS Sixty-eight patients with MBC treated with eribulin were recruited for this retrospective study. The relationship of cytokines, including interleukin (IL)-6, to progression-free survival and OS was examined. CD4+ and CD8+ lymphocyte, MDSCs and regulatory T cell levels were determined in the blood by flow cytometry analysis. RESULTS In our cohort, patients with high IL-6 at baseline had shorter progression-free survival and OS compared with those with low IL-6 (p = 0.0017 and p = 0.0012, respectively). Univariable and multivariable analyses revealed that baseline IL-6 was an independent prognostic factor for OS (p = 0.0058). Importantly, CD8+ lymphocytes were significantly lower and MDSCs were significantly higher in patients with high IL-6, compared to those with low IL-6. CONCLUSION Baseline IL-6 is an important prognostic factor in patients with MBC treated with eribulin. Our results show that high IL-6 is associated with higher levels of MDSCs which suppress anti-tumor immunity, such as CD8+ cells. It appears that eribulin is not particularly effective in patients with high IL-6 due to a poor tumor immune microenvironment.
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Affiliation(s)
- Ayako Bun
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Masayuki Nagahashi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Mamiko Kuroiwa
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Miki Komatsu
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
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De Sanctis R, Jacobs F, Benvenuti C, Gaudio M, Franceschini R, Tancredi R, Pedrazzoli P, Santoro A, Zambelli A. From seaside to bedside: Current evidence and future perspectives in the treatment of breast cancer using marine compounds. Front Pharmacol 2022; 13:909566. [PMID: 36160422 PMCID: PMC9495264 DOI: 10.3389/fphar.2022.909566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
To date, only few marine natural compounds have been proved to be active in breast cancer (BC). The main marine-derived drugs that have been studied for the treatment of BC are tubulin-binding agents (eribulin and plocabulin), DNA-targeting agents (cytarabine and minor groove binders—trabectedin and lurbinectedin) and Antibody-Drug Conjugates (ADCs). Notably, eribulin is the only approved cytotoxic drug for the treatment of advanced BC (ABC), while cytarabine has a limited indication in case of leptomeningeal diffusion of the disease. Also plocabulin showed limited activity in ABC but further research is needed to define its ultimate potential role. The available clinical data for both trabectedin and lurbinectedin are of particular interest in the treatment of BRCA-mutated tumours and HR deficient disease, probably due to a possible immune-mediated mechanism of action. One of the most innovative therapeutic options for the treatment of BC, particularly in TNBC and HER2-positive BC, are ADCs. Some of the ADCs were developed using a specific marine-derived cytotoxic molecule as payload called auristatin. Among these, clinical data are available on ladiratuzumab vedotin and glembatumumab vedotin in TNBC, and on disitamab vedotin and ALT-P7 in HER2-positive patients. A deeper knowledge of the mechanism of action and of the potential predictive factors for response to marine-derived drugs is important for their rational and effective use, alone or in combination. In this narrative review, we discuss the role of marine-derived drugs for the treatment of BC, although most of them are not approved, and the opportunities that could arise from the potential treasure trove of the sea for novel BC therapeutics.
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Affiliation(s)
- Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Chiara Benvenuti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mariangela Gaudio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Raul Franceschini
- Department of Chemistry, Università degli studi di Milano Statale, Milan, Italy
| | - Richard Tancredi
- Medical Oncology Unit, ASST Melegnano Martesana, Ospedale A. Uboldo, Milan, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- *Correspondence: Alberto Zambelli,
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Chen PH, Yeh DC, Tung HH, Lin CY. Prognostic and predictive factors of eribulin in patients with heavily pre-treated metastatic breast cancer. Medicine (Baltimore) 2021; 100:e27859. [PMID: 34964753 PMCID: PMC8615315 DOI: 10.1097/md.0000000000027859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023] Open
Abstract
A predictive marker for efficacy of eribulin administered as different lines of treatment in metastatic breast cancer (MBC) has not been identified. We aimed to determine the predictive factors for efficacy of eribulin administered as different lines of treatment in MBC patients.This restrospective cohort study included 49 heavily pre-treated MBC patients who received either eribulin monotherapy or combination therapy with eribulin and anti-Her2 therapy. Associations between clinical response of eribulin-based treatment, time-to-treatment failure (TTF), and possible predictive markers were investigated.Patients' median age was 55 years; 65% were ER+; 43% were HER2+; and 16% were triple-negative. Median TTF was 5.23 months and longer in non-visceral metastases patients. Eastern Cooperative Oncology Group (ECOG) status was 0-1; eribulin as ≥2nd-line treatment; eribulin combined with dual blockades; lymphocyte-monocyte ratio (LMR) ≥3; and monocyte-lymphocyte ratio (MLR) <0.4. In patients with eribulin as >3rd-line treatment, univariate analysis showed that ECOG status was 0-1, and LMR ≥3 and MLR <0.4 were associated with a low risk of TTF. Multivariate analysis showed that ECOG status 0-1 was an independent protective factor. Leukopenia and neutropenia were the most common manageable adverse events.ECOG status is an independent predictor for TTF, while LMR and MLR may have an interactive effect with other biomarkers (e.g., ECOG status) to predict response in MBC patients receiving eribulin as ≥2nd-line treatment.
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Affiliation(s)
- Pei-Hsin Chen
- Department of Breast Medical Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tanzi Dist., Taichung City, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, Beitou Dist., Taipei City, Taiwan
| | - Dah-Cherng Yeh
- Department of Breast Medical Center, Cheng Ching Hospital Chung Kang Branch, Xitun Dist., Taichung City, Taiwan
| | - Heng-Hsin Tung
- School of Nursing, National Yang Ming Chiao Tung University, Beitou Dist., Taipei City, Taiwan
| | - Chin-Yao Lin
- Department of Breast Medical Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tanzi Dist., Taichung City, Taiwan
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Kamata H, Sadahiro S, Yamori T. Discovery of Inhibitors of Membrane Traffic from a Panel of Clinically Effective Anticancer Drugs. Biol Pharm Bull 2019; 42:814-818. [DOI: 10.1248/bpb.b18-01026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hiroko Kamata
- Division of Molecular Pharmacology, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research
- Graduate School of Medicine, Tokai University
| | | | - Takao Yamori
- Division of Molecular Pharmacology, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research
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De Sanctis R, Agostinetto E, Masci G, Ferraro E, Losurdo A, Viganò A, Antunovic L, Zuradelli M, Torrisi RMC, Santoro A. Predictive Factors of Eribulin Activity in Metastatic Breast Cancer Patients. Oncology 2018; 94 Suppl 1:19-28. [PMID: 30036884 DOI: 10.1159/000489065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Predictive factors of response to eribulin are lacking. We aimed to investigate the activity and safety of eribulin in a real-world population of metastatic breast cancer (MBC) patients and to identify possible predictive factors of progression-free survival (PFS) and objective response. METHODS We retrospectively analyzed 71 eribulin-treated MBC patients. Best response rate, PFS, and adverse events (AEs) were evaluated. The impact of different clinical-pathological factors on PFS was evaluated using the Cox proportional hazards model. Predictive factors of response were identified by discriminant function analysis (DFA). RESULTS Median PFS was 3.75 months (95% CI, 2.39-4.48); 12 patients (16.90%) achieved partial response (PR), 27 (38.03%) stable disease. The most common AEs were fatigue (25.83%), neutropenia (16.56%), and peripheral neuropathy (13.91%). A worse performance status (p = 0.025) and a higher number of metastatic organ sites (p = 0.011) were associated with a worse PFS under eribulin. Overall, in the DFA-predictive model, neutrophil-to-lymphocyte ratio at baseline, estrogen receptor, Ki67, histology, and age were predictive of PR with 100% accuracy. CONCLUSIONS Activity and safety profiles of eribulin were consistent with literature data. Performance status and number of metastatic sites were predictive factors of PFS. DFA could be a promising tool to discriminate responses to eribulin among MBC patients.
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Affiliation(s)
- Rita De Sanctis
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy.,Molecular and Cellular Networks Lab, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, "Sapienza" University, Rome, Italy
| | - Elisa Agostinetto
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Giovanna Masci
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Emanuela Ferraro
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Agnese Losurdo
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Alessandro Viganò
- Molecular and Cellular Networks Lab, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, "Sapienza" University, Rome, Italy
| | - Lidija Antunovic
- Department of Nuclear Medicine, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Monica Zuradelli
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Rosalba Maria Concetta Torrisi
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - Armando Santoro
- Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
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6
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Rossi S, Cassano A, Strippoli A, Schinzari G, D'Argento E, Basso M, Barone C. Prognostic and predictive factors of eribulin efficacy in heavily pretreated patients affected by metastatic breast cancer: correlation with tumor biology and previous therapies. Drugs Context 2017; 6:212506. [PMID: 29167692 PMCID: PMC5699107 DOI: 10.7573/dic.212506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 11/30/2022] Open
Abstract
Background Eribulin mesylate is currently approved in the United States and Europe for the treatment of metastatic breast cancer (MBC). Scope The objective of this retrospective study is to find specific predictive criteria related to patient or tumor characteristics in order to select patients that might benefit the most from eribulin and define the correct treatment sequence. Findings Forty-four patients with MBC who received eribulin in third or subsequent lines of therapy in a single Italian center were considered eligible. Patients were stratified by body mass index, hormonal/HER2 status, and previous therapies. Primary endpoint was progression free survival (PFS), whereas secondary endpoint was disease control rate (DCR). A longer PFS was found in patients with hormone-positive tumors (p=0.0051), in HER2-negative cases (p=0.037), and in overweight patients (p=0.0015). No difference in efficacy was observed when eribulin was administered in third or subsequent lines of therapy. Significantly longer PFS (p<0.0001) and higher DCR (p=0.035) were achieved by patients previously treated with paclitaxel-bevacizumab in comparison to those pretreated with other drug combinations or with anthracyclines. Prior treatment with nab-paclitaxel seems to have a detrimental effect on PFS (p=0.0008). Conclusion Hormone and HER2 status seems a good predictive and prognostic indicator of response to eribulin. Efficacy seems independent from the number of prior therapies, and it is not influenced by prior endocrine treatments and anthracyclines-containing regimens. On the other hand, sensitivity to a prior treatment with paclitaxel-bevacizumab might be predictive of response to eribulin.
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Affiliation(s)
- Sabrina Rossi
- Department of Oncology and Hematology, Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Antonia Strippoli
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Schinzari
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Ettore D'Argento
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Michele Basso
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Carlo Barone
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
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7
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Goodin S, Barbour S, Song J, Berrak E, Cox D. Safety and tolerability of eribulin mesylate in patients with pretreated metastatic breast cancer. Am J Health Syst Pharm 2015; 72:2150-6. [DOI: 10.2146/ajhp140773] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Susan Goodin
- Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick
| | | | - James Song
- Oncology, Eisai Inc., Woodcliff Lakes, NJ
| | | | - David Cox
- Medical Affairs, Ipsen Biopharmaceuticals, Basking Ridge, NJ; at the time of writing he was Group Director, Oncology Medical Strategy, Eisai Inc
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8
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Colley HE, Muthana M, Danson SJ, Jackson LV, Brett ML, Harrison J, Coole SF, Mason DP, Jennings LR, Wong M, Tulasi V, Norman D, Lockey PM, Williams L, Dossetter AG, Griffen EJ, Thompson MJ. An Orally Bioavailable, Indole-3-glyoxylamide Based Series of Tubulin Polymerization Inhibitors Showing Tumor Growth Inhibition in a Mouse Xenograft Model of Head and Neck Cancer. J Med Chem 2015; 58:9309-33. [DOI: 10.1021/acs.jmedchem.5b01312] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Helen E. Colley
- School
of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, U.K
| | - Munitta Muthana
- Department
of Oncology, The University of Sheffield, Medical School, Beech
Hill Road, Sheffield S10
2RX, U.K
| | - Sarah J. Danson
- Academic
Unit of Clinical Oncology and Sheffield Experimental Medicine Centre, Weston Park Hospital, Whitham Road, Sheffield S10 2SJ, U.K
| | - Lucinda V. Jackson
- Department
of Chemistry, University of Sheffield, Brook Hill, Sheffield S3 7HF, U.K
| | - Matthew L. Brett
- Department
of Chemistry, University of Sheffield, Brook Hill, Sheffield S3 7HF, U.K
| | - Joanne Harrison
- Department
of Chemistry, University of Sheffield, Brook Hill, Sheffield S3 7HF, U.K
| | - Sean F. Coole
- Department
of Chemistry, University of Sheffield, Brook Hill, Sheffield S3 7HF, U.K
| | - Daniel P. Mason
- Department
of Chemistry, University of Sheffield, Brook Hill, Sheffield S3 7HF, U.K
| | - Luke R. Jennings
- School
of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, U.K
| | - Melanie Wong
- Charles River, 8−9 Spire
Green Centre, Harlow, Harlow, Essex CM19 5TR, U.K
| | - Vamshi Tulasi
- Charles River, 8−9 Spire
Green Centre, Harlow, Harlow, Essex CM19 5TR, U.K
| | - Dennis Norman
- Charles River, 8−9 Spire
Green Centre, Harlow, Harlow, Essex CM19 5TR, U.K
| | - Peter M. Lockey
- Charles River, 8−9 Spire
Green Centre, Harlow, Harlow, Essex CM19 5TR, U.K
| | - Lynne Williams
- Department
of Oncology, The University of Sheffield, Medical School, Beech
Hill Road, Sheffield S10
2RX, U.K
| | - Alexander G. Dossetter
- MedChemica Limited, Ebenezer House,
Ryecroft, Newcastle-Under-Lyme, Staffordshire ST5 2BE, U.K
| | - Edward J. Griffen
- MedChemica Limited, Ebenezer House,
Ryecroft, Newcastle-Under-Lyme, Staffordshire ST5 2BE, U.K
| | - Mark J. Thompson
- Department
of Chemistry, University of Sheffield, Brook Hill, Sheffield S3 7HF, U.K
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9
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Dell'Ova M, De Maio E, Guiu S, Roca L, Dalenc F, Durigova A, Pinguet F, Bekhtari K, Jacot W, Pouderoux S. Tumour biology, metastatic sites and taxanes sensitivity as determinants of eribulin mesylate efficacy in breast cancer: results from the ERIBEX retrospective, international, multicenter study. BMC Cancer 2015; 15:659. [PMID: 26449988 PMCID: PMC4599752 DOI: 10.1186/s12885-015-1673-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 10/01/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Our retrospective, international study aimed at evaluating the activity and safety of eribulin mesylate (EM) in pretreated metastatic breast cancer (MBC) in a routine clinical setting. METHODS Patients treated with EM for a locally advanced or MBC between March 2011 and January 2014 were included in the study. Clinical and biological assessment of toxicity was performed at each visit. Tumour response was assessed every 3 cycles of treatment. A database was created to collect clinical, pathological and treatment data. RESULTS Two hundred and fifty-eight patients were included in the study. Median age was 59 years old. Tumours were Hormone Receptor (HR)-positive (73.3 %) HER2-positive (10.2 %), and triple negative (TN, 22.5 %). 86.4 % of the patients presented with visceral metastases, mainly in the liver (67.4 %). Median previous metastatic chemotherapies number was 4 [1-9]. Previous treatments included anthracyclines and/or taxanes (100 %) and capecitabine (90.7 %). Median number of EM cycles was 5 [1-19]. The relative dose intensity was 0.917. At the time of analysis (median follow-up of 13.9 months), 42.3 % of the patients were still alive. The objective response rate was 25.2 % (95 %CI: 20-31) with a 36.1 % clinical benefit rate (CBR). Median time to progression (TTP) and overall survival were 3.97 (95 %CI: 3.25-4.3) and 11.2 (95 %CI: 9.3-12.1) months, respectively. One- and 2-year survival rates were 45.5 and 8.5 %, respectively. In multivariate analysis, HER2 positivity (HR = 0.29), the presence of lung metastases (HR = 2.49) and primary taxanes resistance (HR = 2.36) were the only three independent CBR predictive factors, while HR positivity (HR = 0.67), the presence of lung metastases (HR = 1.52) and primary taxanes resistance (HR = 1.50) were the only three TTP independent prognostic factors. Treatment was globally well tolerated. Most common grade 3-4 toxicities were neutropenia (20.9 %), peripheral neuropathy (3.9 %), anaemia (1.6 %), liver dysfunction (0.8 %) and thrombocytopenia (0.4 %). Thirteen patients (5 %) developed febrile neutropenia. CONCLUSION EM is an effective new option in heavily pretreated MBC, with a favourable efficacy/safety ratio in a clinical practice setting. Our results comfort the use of this new molecule and pledge for the evaluation of EM-trastuzumab combination in this setting. Tumour biology, primary taxanes sensitivity and metastatic sites could represent useful predictive and prognostic factors.
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Affiliation(s)
- Mélodie Dell'Ova
- Département de Pharmacie Clinique, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
| | - Eléonora De Maio
- Medical Oncology Department, Institut Claudius Regaud, IUCT- Oncopole, Toulouse, France.
| | - Séverine Guiu
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon, France.
- Breast Center (CePO), University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | - Lise Roca
- Département de Biostatistiques, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
| | - Florence Dalenc
- Medical Oncology Department, Institut Claudius Regaud, IUCT- Oncopole, Toulouse, France.
| | - Anna Durigova
- Département d'Oncologie Médicale, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
- Medical Oncology Department, University Hospital of Geneva, Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland.
| | - Frédéric Pinguet
- Département de Pharmacie Clinique, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
| | - Khedidja Bekhtari
- Département de Pharmacie Clinique, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
| | - William Jacot
- Département d'Oncologie Médicale, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
| | - Stéphane Pouderoux
- Département d'Oncologie Médicale, Institut régional du Cancer de Montpellier (ICM), 208, rue des Apothicaires, 34298, Montpellier Cedex 5, France.
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10
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Schwartzberg LS. Clinical impact of eribulin in the treatment of breast cancer. BREAST CANCER MANAGEMENT 2014. [DOI: 10.2217/bmt.14.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Metastatic breast cancer is considered incurable, with a 5-year survival of approximately 23%. However, sequential chemotherapy regimens produce clinical benefit for patients, including prolonged progression-free and overall survival times. Eribulin is a convenient (<5 min infusion) and novel treatment that has shown activity and efficacy and tolerability in advanced breast cancer patients in Phase II and Phase III trials. Eribulin has also shown encouraging results as first-line treatment, either alone in patients with HER2- disease or in combination with trastuzumab in patients with HER2+ disease, in Phase II trials.
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11
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Ke CS, Liu HS, Yen CH, Huang GC, Cheng HC, Huang CYF, Su CL. Curcumin-induced Aurora-A suppression not only causes mitotic defect and cell cycle arrest but also alters chemosensitivity to anticancer drugs. J Nutr Biochem 2014; 25:526-39. [PMID: 24613085 DOI: 10.1016/j.jnutbio.2014.01.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 12/29/2013] [Accepted: 01/08/2014] [Indexed: 01/19/2023]
Abstract
Overexpression of oncoprotein Aurora-A increases drug resistance and promotes lung metastasis of breast cancer cells. Curcumin is an active anticancer compound in turmeric and curry. Here we observed that Aurora-A protein and kinase activity were reduced in curcumin-treated human breast chemoresistant nonmetastatic MCF-7 and highly metastatic cancer MDA-MB-231 cells. Curcumin acts in a similar manner to Aurora-A small interfering RNA (siRNA), resulting in monopolar spindle formation, S and G2/M arrest, and cell division reduction. Ectopic Aurora-A extinguished the curcumin effects. The anticancer effects of curcumin were enhanced by Aurora-A siRNA and produced additivity and synergism effects in cell division and monopolar phenotype, respectively. Combination treatment with curcumin overrode the chemoresistance to four Food and Drug Administration (FDA)-approved anticancer drugs (ixabepilone, cisplatin, vinorelbine, or everolimus) in MDA-MB-231 cells, which was characterized by a decrease in cell viability and the occurrence of an additivity or synergy effect. Ectopic expression of Aurora-A attenuated curcumin-enhanced chemosensitivity to these four tested drugs. A similar benefit of curcumin was observed in MCF-7 cells treated with ixabepilone, the primary systemic therapy to patients with invasive breast cancer (stages IIA-IIIB) before surgery. Antagonism effect was observed when MCF-7 cells were treated with curcumin plus cisplatin, vinorelbine or everolimus. Curcumin-induced enhancement in chemosensitivity was paralleled by significant increases (additivity or synergy effect) in apoptosis and cell cycle arrest at S and G2/M phases, the consequences of Aurora-A inhibition. These results suggest that a combination of curcumin with FDA-approved anticancer drugs warrants further assessment with a view to developing a novel clinical treatment for breast cancer.
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Affiliation(s)
- Ching-Shiun Ke
- Department of Human Development and Family Studies, National Taiwan Normal University, Taipei 106, Taiwan
| | - Hsiao-Sheng Liu
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; Center of Infectious Disease and Signaling Research Center, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Cheng-Hsin Yen
- Department of Human Development and Family Studies, National Taiwan Normal University, Taipei 106, Taiwan
| | - Guan-Cheng Huang
- Division of Hemato-oncology, Department of Internal Medicine, Yuan's General Hospital, Kaohsiung 802, Taiwan
| | - Hung-Chi Cheng
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chi-Ying F Huang
- Institute of BioPharmaceutical Sciences, National Yang-Ming University, Taipei 112, Taiwan
| | - Chun-Li Su
- Department of Human Development and Family Studies, National Taiwan Normal University, Taipei 106, Taiwan.
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Yu Y, Desjardins C, Saxton P, Lai G, Schuck E, Wong YN. Characterization of the pharmacokinetics of a liposomal formulation of eribulin mesylate (E7389) in mice. Int J Pharm 2013; 443:9-16. [PMID: 23313921 DOI: 10.1016/j.ijpharm.2013.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 12/06/2012] [Accepted: 01/02/2013] [Indexed: 11/30/2022]
Abstract
Eribulin mesylate (E7389), a tubulin and microtubule inhibitor, has been approved to treat metastatic breast cancer in certain patient populations. A liposomal formulation of E7389, E7389-LF, aims to increase the therapeutic profile of E7389. As determining the free drug concentration is crucial for the assessment of efficacy and toxicity of liposomal drug, in this study, an ultracentrifugation method coupled with LC-MS/MS was developed to separate the free E7389 from liposomal and protein bound E7389. The pharmacokinetics of the free E7389 after dosing either E7389 or E7389-LF was characterized. The concentration ratio of E7389 in ultracentrifuged mice plasma (UCM) vs E7389 in plasma after a 2mg/kg i.v. of E7389 ranged from 54.19% to 65.41%, which was similar to the free fraction in the mouse plasma. The respective concentration ratio of E7389 in UCM vs E7389 in plasma after a 2mg/kg i.v. of E7389-LF ranged from 0.07% to 0.59%, and the exposure, expressed as AUC, of UCM/plasma ratio was determined to be 0.2%. Pharmacokinetic modeling was performed to estimate the release kinetics of E7389 from E7389-LF, and the release was best described by a first order rate constant k(rel) 0.078 h(-1). Sensitivity analysis demonstrated that further decrease the release rate constant by adjusting liposome formulation would lead to decreased C(max) and much longer half-life of UCM E7389, which might result in better efficacy and lower toxicity.
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Affiliation(s)
- Yanke Yu
- DMPK, BA-CFU, Eisai Inc., 4 Corporate Drive, Andover, MA 01810, USA.
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Current status on marine products with reversal effect on cancer multidrug resistance. Mar Drugs 2012; 10:2312-2321. [PMID: 23170086 PMCID: PMC3497025 DOI: 10.3390/md10102312] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 09/13/2012] [Accepted: 09/29/2012] [Indexed: 01/03/2023] Open
Abstract
The resistance of tumor cells to a broad range of anticancer agents continues to be a problem for the success of cancer chemotherapy. Multidrug resistance (MDR) is due in part to three drug transporter proteins: ABCB1/P-glycoprotein (P-gp), ABCC1/multidrug resistance protein 1 (MRP1) and ABCG2/breast cancer resistance protein (BCRP). These transporters are part of the ATP-binding cassette (ABC) superfamily, whose members function as ATP-dependent drug-efflux pumps. Their activity can be blocked by various drugs such as verapamil (calcium channel blocker) and cyclosporin A (immunosuppressive agent), etc. These compounds are called MDR modulators or reversals. This review highlights several marine natural products with reversal effect on multidrug resistance in cancer, including agosterol A, ecteinascidin 743, sipholane triterpenoids, bryostatin 1, and welwitindolinones.
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LaBarbera DV, Reid BG, Yoo BH. The multicellular tumor spheroid model for high-throughput cancer drug discovery. Expert Opin Drug Discov 2012; 7:819-30. [DOI: 10.1517/17460441.2012.708334] [Citation(s) in RCA: 178] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ishibashi M, A. Arai M. Bioactive Natural Products from Myxomycetes Having Effects on Signaling Pathways. HETEROCYCLES 2012. [DOI: 10.3987/rev-12-732] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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