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Pouwels XGLV, Geurts SME, Ramaekers BLT, Erdkamp F, Vriens BEPJ, Aaldering KNA, van de Wouw AJ, Dercksen MW, Smilde TJ, Peters NAJB, Riel JMV, Pepels MJ, Heijnen-Mommers J, Joore MA, Tjan-Heijnen VCG, de Boer M. The relative effectiveness of eribulin for advanced breast cancer treatment: a study of the southeast Netherlands advanced breast cancer registry. Acta Oncol 2020; 59:82-89. [PMID: 31583931 DOI: 10.1080/0284186x.2019.1670356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Eribulin provided significant overall survival (OS) benefit in heavily pretreated advanced breast cancer patients in the EMBRACE trial. We investigated the use of eribulin in daily clinical practice, the relative effectiveness of eribulin versus non-eribulin chemotherapy, and the safety of eribulin in real-world patients included in the SOutheast Netherlands Advanced BREast cancer (SONABRE) registry.Material and methods: Patients treated with eribulin and eligible patients for eribulin who received a different chemotherapy (i.e., non-eribulin group) in ten hospitals in 2013-2017 were included. A multivariate matching algorithm was applied to correct for differences in baseline characteristics between the groups, including the number of previous treatment lines. Progression-free survival (PFS) and OS of eribulin were compared with the matched non-eribulin group through Kaplan-Meier curves and multivariate Cox proportional hazard models. The occurrence of dose delay and reduction was described.Results: Forty-five patients received eribulin according to its registration criteria and 74 patients were eligible for eribulin but received non-eribulin chemotherapy. Matching increased the similarity in baseline characteristics between the eribulin and non-eribulin groups. Median PFS was 3.5 months (95% confidence interval (CI): 2.7-5.5) in the eribulin group and 3.2 months (95% CI: 2.0-4.8) in the matched non-eribulin group (adjusted hazard ratio (HR): 0.83, 95% CI: 0.49-1.38). Median OS was 5.9 months (95% CI: 4.6-11.0) and 5.2 months (95% CI: 4.6-9.5) in the eribulin and non-eribulin groups, respectively (adjusted HR: 0.66, 95% CI: 0.38-1.13). Dose delay or reduction occurred in 14 patients (31%) receiving eribulin.Conclusions: No difference in PFS and OS was observed between eribulin and non-eribulin treated patients. Eribulin had a manageable toxicity profile.
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Affiliation(s)
- X. G. L. V. Pouwels
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - S. M. E. Geurts
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - B. L. T. Ramaekers
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - F. Erdkamp
- Department of Internal Medicine, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
| | - B. E. P. J. Vriens
- Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - K. N. A. Aaldering
- Department of Internal Medicine, Laurentius Hospital, Roermond, The Netherlands
| | - A. J. van de Wouw
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - M. W. Dercksen
- Department of Internal Medicine, Máxima Medical Centre, Veldhoven/Eindhoven, The Netherlands
| | - T. J. Smilde
- Department of Internal Medicine, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands
| | - N. A. J. B. Peters
- Department of Internal Medicine, Sint Jans Gasthuis, Weert, The Netherlands
| | - J. M. van Riel
- Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - M. J. Pepels
- Department of Internal Medicine, Elkerliek Hospital, Helmond, The Netherlands
| | - J. Heijnen-Mommers
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M. A. Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - V. C. G. Tjan-Heijnen
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M. de Boer
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Ditsatham C, Chitapanarux I, Somwangprasert A, Watcharachan K, Wongmaneerung P, Charoentum C, Chewaskulyong B, Chakrabandhu S, Onchan W, Teeyasuntranonn A, Sripan P. Outcome of eribulin as a late treatment line for Thai metastatic breast cancer patients. Onco Targets Ther 2018; 11:4443-4447. [PMID: 30104885 PMCID: PMC6074808 DOI: 10.2147/ott.s166399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background We report the safety and efficacy of eribulin as a late treatment line in Thai metastatic breast cancer (MBC) patients. Patients and methods A total of 30 MBC patients treated with eribulin between January 2014 and January 2017 were retrospectively analyzed. The patients were scheduled to receive 1.4 mg/m2 of eribulin on day 1, day 8 and subsequently every 21 days. All patients had previously received at least three chemotherapy regimens including anthracycline and taxane. Response rate and progression-free survival (PFS) were analyzed. Results The median age was 56 years (range, 40–74 years), with a median follow-up time of 5.7 months (range, 0.2–25 months). The overall response rate was 30% (nine patients): four patients had triple-negative breast cancer, three patients had luminal B breast cancer and two patients had luminal A breast cancer. The median PFS was 2.9 months (range, 0.2–14 months). The median number of previous chemotherapy regimens was 4 (range, 3–9). Univariate analysis showed that the number of regimens (four or fewer) prior to eribulin was statistically associated with superior PFS (P = 0.009). Multivariate analysis also showed similar statistical association between number of prior regimens (four or fewer) and better PFS adjusted by age group (≥50 years; hazard ratio = 1.29; 95% CI: 1.0–1.65; P = 0.046). There were no toxic deaths or grade 4 toxicities. Nine (30%) patients had grade 3 anemia toxicities, and the other common toxicities were leukopenia and neutropenia. Four (13%) patients required dose reduction and 16 (53%) patients required dose delay because of toxicities. Conclusion Eribulin is an effective drug for heavily pretreated MBC patients with tolerable toxicities. The benefit was superior in patients who received fewer than four previous chemotherapy regimens.
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Affiliation(s)
| | - Imjai Chitapanarux
- Division of Radiation Oncology, .,Northern Thai Research Group of Radiation Oncology, .,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital,
| | | | | | | | | | | | | | | | - Anongnart Teeyasuntranonn
- Pharmacy Division, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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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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Srinivasa BJ, Lalkota BP, Badarke G, Hazarika D, Mohammad N, Sapkota S, Khanderia M, Tousif D, Rao R, Ram A, Patil S, Naik R. Prospective Analysis of Patients with Metastatic Breast Cancer receiving Eribulin Mesylate as Second or More Lines of Chemotherapy: An Indian Experience. Clin Med Insights Oncol 2018; 12:1179554918782475. [PMID: 30046259 PMCID: PMC6055235 DOI: 10.1177/1179554918782475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 05/18/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Eribulin mesylate is a non-taxane microtubule inhibitor which can be used after anthracycline and taxane treatment in patients with metastatic breast cancer (MBC). The purpose of this study was to investigate the efficacy and safety of eribulin monotherapy in heavily pretreated patients with MBC. METHODS In this study, a total of 45 eligible patients with MBC who received eribulin in HCG Cancer Speciality Center from November 2014 to March 2016 were prospectively analyzed. Breslow (generalized Wilcoxon) survival analysis was carried out for progression-free survival and for overall survival. Patients were excluded if they had not taken treatment for 3 cycles and defaulted/expired during the treatment. RESULTS In this study, median age of patients was 52 years. A total of 27 (60%) patients had estrogen receptor and progesterone receptor (PR) positive primary tumors, whereas HER2 was overexpressed or amplified in 7 (15.6%); a triple negative subtype was recorded in 13 patients (28.9%). Regarding toxicity, 30 patients (66.67%) tolerated treatment well and 3 patients (6.67%) got anemia, 6 patients (13.3%) experienced neutropenia, and 7 (15.62%) patients had neurological toxicity. About 14 (31.1%) patients showed PR, 12 (26.7%) patients had stable disease (SD), whereas 19 (42.25%) patients showed progression disease (PD). Response evaluation at 6 cycles was possible in 18 patients and revealed that 4 (22.5%) patients showed PR, 10 (55.5%) patients had SD, whereas 4 (22.2%) patients had PD. Progression-free survival of the overall study population was 3.95 months. CONCLUSIONS Eribulin mesylate is efficacious and tolerable chemotherapy as second- and third-line treatment options for MBC.
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Affiliation(s)
- BJ Srinivasa
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
| | | | - Girish Badarke
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
| | - Diganta Hazarika
- Department of Histopathology, Molecular Pathology & Cytogenetics, Triesta Sciences R&D (A Unit of HCG Cancer Speciality Center), Bangalore, India
| | - Nasiruddin Mohammad
- Department of Histopathology, Molecular Pathology & Cytogenetics, Triesta Sciences R&D (A Unit of HCG Cancer Speciality Center), Bangalore, India
| | - Sulav Sapkota
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
| | - Mansi Khanderia
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
| | - D Tousif
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
| | - Raghavendra Rao
- Center for Academics and Research, HCG Foundation, Bangalore, India
| | - Amritanshu Ram
- Center for Academics and Research, HCG Foundation, Bangalore, India
| | - Shekar Patil
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
| | - Radheshyam Naik
- Department of Medical Oncology, HCG Cancer Speciality Center, Bangalore, India
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Quaquarini E, Sottotetti F, D'Ambrosio D, Malovini A, Morganti S, Marinello A, Pavesi L, Frascaroli M. Eribulin across multiple lines of chemotherapy: a retrospective study on quality of life and efficacy in metastatic breast cancer patients. Future Oncol 2017; 13:11-23. [PMID: 28481185 DOI: 10.2217/fon-2016-0517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study evaluates efficacy, tolerability and health-related quality of life of eribulin in patients with metastatic breast cancer. Predictive and/or prognostic factors of outcome were also analyzed. Among 44 women receiving eribulin mesylate, one patient had a complete response, 22.7% a partial response and 25% a stable disease. Median overall survival and median progression-free survival were 11.8 and 4.5 months, respectively. Treatment was well tolerated; the most frequent adverse events were neutropenia (52%), leukopenia (50%), fatigue (38%) and alopecia (40%). No significant reductions of health-related quality of life parameters were observed. Disease control during previous chemotherapy lines was related with better outcome with eribulin. In conclusion, eribulin treatment should be considered in a multiple chemotherapy lines strategy in metastatic breast cancer.
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Affiliation(s)
- Erica Quaquarini
- Operative Unit of Medical Oncology, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
| | - Federico Sottotetti
- Operative Unit of Medical Oncology, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
| | - Daniela D'Ambrosio
- Medical Physics Department, IRCCS Fondazione Maugeri, Via Salvatore Maugeri 4, 27100 Pavia, Italy
| | - Alberto Malovini
- Department of Computer Engineering & Systems Science, University of Pavia, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
| | - Stefania Morganti
- Operative Unit of Medical Oncology, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
| | - Arianna Marinello
- Operative Unit of Medical Oncology, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
| | - Lorenzo Pavesi
- Operative Unit of Medical Oncology, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
| | - Mara Frascaroli
- Operative Unit of Medical Oncology, Fondazione Maugeri-IRCCS, Via Maugeri 10, 27100 Pavia, Italy
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Garrone O, Miraglio E, Vandone AM, Vanella P, Lingua D, Merlano MC. Eribulin in advanced breast cancer: safety, efficacy and new perspectives. Future Oncol 2017; 13:2759-2769. [PMID: 29219017 DOI: 10.2217/fon-2017-0283] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Eribulin is a synthetic analog of halichondrin B belonging to microtubule-targeted agents with a distinct mechanism of inhibition of microtubule dynamics. This molecule has multiple nonmitotic effects on tumor biology, exhibiting effects on epithelial-mesenchimal transition and tumor vasculature. We review here preclinical and clinical studies on eribulin. The mitotic and nonmitotic effects together with its favorable safety profile make eribulin a unique drug with high potential in the treatment of metastatic breast cancer. The new emphasis of eribulin mechanism of action on vascular remodeling, microenvironment modifications and reversal of epithelial-mesenchimal transition paves the way to rethinking the use of the drug in an immunological perspective.
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Affiliation(s)
- Ornella Garrone
- Medical Oncology A.O. S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Emanuela Miraglio
- Medical Oncology A.O. S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Anna Maria Vandone
- Medical Oncology A.O. S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Paola Vanella
- Medical Oncology A.O. S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Daniele Lingua
- Medical Oncology A.O. S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Marco C Merlano
- Medical Oncology A.O. S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
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7
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A systematic review and pooled analysis of retrospective series of eribulin in metastatic breast cancer. Anticancer Drugs 2017; 28:557-564. [DOI: 10.1097/cad.0000000000000493] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Vincenzi B, Armento G, Spalato Ceruso M, Catania G, Leakos M, Santini D, Minotti G, Tonini G. Drug-induced hepatotoxicity in cancer patients - implication for treatment. Expert Opin Drug Saf 2016; 15:1219-38. [PMID: 27232067 DOI: 10.1080/14740338.2016.1194824] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION All anticancer drugs can cause idiosyncratic liver injury. Therefore, hepatoprotective agents assume particular importance to preserve liver function. Hepatic injury represents 10% of cases of acute hepatitis in adults; drug-related damage is still misjudged because of relative clinical underestimation and difficult differential diagnosis. Chemotherapeutic agents can produce liver toxicity through different pathways, resulting in different categories of liver injuries, but these drugs are not homogeneously hepatotoxic. Frequently, anticancer-induced hepatotoxicity is idiosyncratic and influenced by multiple factors. AREAS COVERED The aim of this paper is to perform a review of the literature regarding anticancer-induced liver toxicity. We described hepatotoxicity mechanisms of principal anticancer agents and respective dose reductions. Furthermore, we reviewed studies on hepatoprotectors and their optimal use. Tiopronin, magnesium isoglycyrrhizinate and S-Adenosylmethionine (AdoMet) demonstrated, in some small studies, a potential hepatoprotective activity. EXPERT OPINION Actually, in the literature only small experiences are reported. Even though hepatoprotective agents seem to be useful in the oncologic setting, the lack of well-designed prospective Phase III randomized controlled trials is a major limit in the introduction of hepatoprotectors in cancer patients and these kind of studies are warranted to support their use and to give further recommendations for the clinical practice.
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Affiliation(s)
- Bruno Vincenzi
- a Medical Oncology Department, Campus Bio-Medico , University of Rome , Rome , Italy
| | - Grazia Armento
- a Medical Oncology Department, Campus Bio-Medico , University of Rome , Rome , Italy
| | | | - Giovanna Catania
- a Medical Oncology Department, Campus Bio-Medico , University of Rome , Rome , Italy.,b Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences , University of Palermo , Palermo , Italy
| | - Mark Leakos
- a Medical Oncology Department, Campus Bio-Medico , University of Rome , Rome , Italy
| | - Daniele Santini
- a Medical Oncology Department, Campus Bio-Medico , University of Rome , Rome , Italy
| | - Giorgio Minotti
- c Clinical Pharmacology Department , Campus Bio-Medico, University of Rome , Rome , Italy
| | - Giuseppe Tonini
- a Medical Oncology Department, Campus Bio-Medico , University of Rome , Rome , Italy
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9
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Garrone O, Montemurro F, Saggia C, La Verde N, Vandone AM, Airoldi M, De Conciliis E, Donadio M, Lucio F, Polimeni MA, Oletti MV, Giacobino A, Merlano MC. Eribulin in pretreated metastatic breast cancer patients: results of the TROTTER trial-a multicenter retrospective study of eribulin in real life. SPRINGERPLUS 2016; 5:59. [PMID: 26835238 PMCID: PMC4720621 DOI: 10.1186/s40064-016-1700-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 01/08/2016] [Indexed: 11/10/2022]
Abstract
This retrospective multicenter analysis was aimed to evaluate clinical activity and tolerability of eribulin in pretreated metastatic breast cancer patients in clinical practice. Patients treated with eribulin from January 2012 to July 2013 were enrolled in the observational study from 10 italian hospitals. Tumor and toxicity evaluation were performed according to Agenzia Italiana Farmaco. One-hundred and thirteen patients were included in the study. Median age 62 years old. 71.7 % of the patients had visceral involvement and the majority had a burden of disease involving two or more organs with a median number of 2 (1-6). The median number of previous chemotherapy regimens for advanced disease was 3 (1-10). Median number of eribulin cycles was 4 (1-27). Overall response rate was 24 % (95 % CI 16.0-31.8). Clinical benefit rate, was 35.4 % (95 % CI 26.6-44.2). At a median follow-up of 29.6 months (8.3-41.9) the median progression free survival was 3.3 months (0.6-26.7; 95 % CI 2.4-4.2), and the median overall survival 11.6 months (0.6-33.3; 95 % CI 8.7-14.5). No correlation was recorded between subtypes in terms of ORR and CBR. Toxicity was manageable. Main common grade 3-4 toxicities were neutropenia (19.4 %), febrile neutropenia (0.9 %), asthenia (3.5 %), abnormal liver function test (1.8 %), stomatitis (0.9 %). Our results confirm that treatment with eribulin is feasible and safe in real-world patients.
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Affiliation(s)
- Ornella Garrone
- Medical Oncology, A.O. Ospedale di Insegnamento S. Croce e Carle, V. M. Coppino, 26, 12100 Cuneo, Italy
| | - Filippo Montemurro
- Investigative Clinical Oncology, Fondazione del Piemonte per l'Oncologia, Candiolo Cancer Institute (IRCCS), Strada Provinciale 142, 10060 Candiolo, Turin, Italy
| | - Chiara Saggia
- Medical Oncology, A.O.U. Maggiore della Carità, C. G. Mazzini, 28, 28100 Novara, Italy
| | - Nicla La Verde
- Department of Oncology, A.O. Fatebenefratelli & Oftalmico, C. di Porta Nuova, 25, 20121 Milan, Italy
| | - Anna Maria Vandone
- Medical Oncology, A.O. Ospedale di Insegnamento S. Croce e Carle, V. M. Coppino, 26, 12100 Cuneo, Italy
| | - Mario Airoldi
- Department of Medical Oncology 2, A.O.U. Città della Salute e della Scienza, C. Bramante, 88, 10126 Turin, Italy
| | - Enrico De Conciliis
- Medical Oncology, Ospedale Cardinal Massaia, C. D. Alighieri, 201, 14100 Asti, Italy
| | - Michela Donadio
- Breast Unit, A.O.U. Città della Salute e della Scienza, C. Bramante, 88, 10126 Turin, Italy
| | - Francesco Lucio
- Radiotherapy Oncology, A.O. Ospedale di Insegnamento S. Croce e Carle, V. M. Coppino, 26, 12100 Cuneo, Italy
| | | | - Maria Vittoria Oletti
- Medical Oncology, Ospedale S. Spirito, V. G. Giolitti, 2, 15033 Casale Monferrato, Italy
| | - Alice Giacobino
- Department of Oncology, Ospedale degli Infermi, V. Ponderanesi, 2, 13875 Ponderano, Italy
| | - Marco Carlo Merlano
- Medical Oncology, A.O. Ospedale di Insegnamento S. Croce e Carle, V. M. Coppino, 26, 12100 Cuneo, Italy
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10
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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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11
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Paillard MJ, Curtit E, Dobi E, Mansi L, Bazan F, Villanueva C, Chaigneau L, Montcuquet P, Meneveau N, Thiery-Vuillemin A, Nerich V, Pivot X. Efficacité, tolérance et coût de l’éribuline chez des patientes présentant un cancer du sein métastatique. Bull Cancer 2015; 102:737-48. [DOI: 10.1016/j.bulcan.2015.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 03/25/2015] [Indexed: 01/28/2023]
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12
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Leo L, Caputo F, Sarno AD, Garofano T, Andreozzi F, Massaro MG, Montesarchio V. Response to eribulin in a difficult-to-treat, heavily pretreated breast cancer patient: a case report. Future Oncol 2015; 11:27-30. [DOI: 10.2217/fon.15.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In this short paper, we report our experience with eribulin mesylate in a heavily pretreated breast cancer patient with multiple bone metastases. The patient had been treated with doxorubicin, cyclophosphamide, methotrexate, fluorouracil, tamoxifen, letrozole, LH-RH analogs, fulvestrant, bevacizumab and paclitaxel and liposomal doxorubicin. In November 2013 treatment with eribulin ready to use solution (1.23 mg/m2 days 1 and 8 of a 21-day cycle) was started and administered for a total of 14 courses. After six cycles of eribulin, evaluation with MRI showed a marked decrease in neoplastic involvement and replacement of osteolytic lesions with osteoblastic ones. No unexpected acute toxicity was observed. Although with all the limitations of any anecdotal report, our experience documents the efficacy and safety of eribulin in this difficult-to-treat patient who had been treated with multiple lines of chemotherapy.
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Affiliation(s)
- Luigi Leo
- Oncology Unit, Azienda Ospedaliera dei Colli, Naples, Italy
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13
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Kessler L, Falato C, Margolin S, Bergh J, Foukakis T. A retrospective safety and efficacy analysis of the first patients treated with eribulin for metastatic breast cancer in Stockholm, Sweden. Acta Oncol 2015; 54:522-9. [PMID: 25383448 DOI: 10.3109/0284186x.2014.973063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUNDS Eribulin is a non-taxane, microtubule dynamics inhibitor approved for the treatment of patients with metastatic breast cancer (MBC) in Europe in March 2011. MATERIAL AND METHODS For the purpose of an internal quality control, all patients with MBC treated with eribulin at Karolinska University Hospital were registered in a database. Clinical data were collected retrospectively for patients that were registered by August 2012 and safety and efficacy of eribulin were evaluated. Treatment toxicity including fatigue, neurotoxicity and infection was graded according to CTCAE v4.0. Objective response to treatment was investigated using routinely performed radiological assessments. When only clinical assessments were made, the evaluation of the treating physician was used. Furthermore, the efficacy of eribulin was investigated in different tumor subtypes. RESULTS Forty-eight patients who received at least one cycle of eribulin were identified. Most patients were heavily pretreated with a median of 3 (range 1-7) previous chemotherapy lines prior to eribulin. Median patient age was 56 years (range 35-74). At the end of the analysis, 23 patients were alive and two were still treated with eribulin. No hypersensitivity reactions and no toxic deaths were seen. Fatigue grade 3-4 was observed in three patients (6.3%). One patient experienced grade 4 neurotoxicity. Grade 3-4 neutropenia was documented in 18.8%, and three patients were treated for a grade 3 infection. Interestingly, three individuals developed Herpes zoster reactivation. One patient responded to treatment with complete remission, while 33.3% had a partial response. 48% of all patients had a clinical benefit (objective response or stable disease for more than six months). CONCLUSIONS Eribulin administered outside of a clinical trial in patients with advanced breast cancer was safe and well tolerated. A clinical benefit was seen in half of the cases. No statistically significant differences in objective response or survival were observed between histopathological subgroups.
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Affiliation(s)
- Luisa Kessler
- Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital , Stockholm , Sweden
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14
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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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15
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Gamucci T, Michelotti A, Pizzuti L, Mentuccia L, Landucci E, Sperduti I, Di Lauro L, Fabi A, Tonini G, Sini V, Salesi N, Ferrarini I, Vaccaro A, Pavese I, Veltri E, Moscetti L, Marchetti P, Vici P. Eribulin mesylate in pretreated breast cancer patients: a multicenter retrospective observational study. J Cancer 2014; 5:320-7. [PMID: 24723974 PMCID: PMC3982178 DOI: 10.7150/jca.8748] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/26/2014] [Indexed: 02/05/2023] Open
Abstract
Background: Eribulin was recently approved in patients progressing after being treated with anthracyclines and taxanes and after two or more chemotherapy lines for advanced disease. Objectives: This multicenter observational retrospective study was performed in order to evaluate activity and tolerability of eribulin in real-world patient population. Methods: 133 advanced breast cancer patients pretreated with ≥ 2 chemotherapy lines for metastatic disease were retrospectively enrolled in the observational trial in 11 italian cancer centres. Results: A median of 5 cycles of eribulin (range, 1-15) were administered. Twenty-eight partial responses were observed, for an overall response rate of 21.1% (95%CI,14.1-28.0). A stable disease was recorded in 57 patients (42.8%), and a clinical benefit (response or stable disease lasting ≥ six months) was observed in 51 patients (38.3%, 95%CI, 30.1-46.6). The subgroup analysis showed that a significant improvement in term of partial response and clinical benefit was achieved when eribulin was administered in HER-2 negative tumors (p=0.01 and p=0.004, respectively) and when it is given as third-line (p=0.09 and p=0.02, respectively). Toxicity was manageable; fatigue is the most common side effect observed, usually of low-grade, and clearly cumulative-dose related. Conclusions: In this retrospective, observational analysis eribulin confirmed its efficacy and manageable tolerability even in real-world population and in heavily pretreated patients.
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Affiliation(s)
- Teresa Gamucci
- 1. Medical Oncology Unit ASL Frosinone, Frosinone, Italy
| | - Andrea Michelotti
- 2. Oncology Unit I, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Laura Pizzuti
- 3. Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Isabella Sperduti
- 4. Biostatistics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Luigi Di Lauro
- 3. Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandra Fabi
- 5. Division of Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Tonini
- 6. Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - Valentina Sini
- 7. Oncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Nello Salesi
- 8. Medical Oncology, S.M. Goretti Hospital, Latina, Italy
| | - Ilaria Ferrarini
- 2. Oncology Unit I, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Angela Vaccaro
- 1. Medical Oncology Unit ASL Frosinone, Frosinone, Italy
| | - Ida Pavese
- 9. Medical Oncology, San Pietro Hospital, Rome, Italy
| | - Enzo Veltri
- 8. Medical Oncology, S.M. Goretti Hospital, Latina, Italy
| | - Luca Moscetti
- 10. Division of Medical Oncology, Department of Oncology, Belcolle Hospital, ASL Viterbo, Viterbo, Italy
| | - Paolo Marchetti
- 7. Oncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Patrizia Vici
- 3. Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy
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