For many patients with metastatic breast cancer, a resistance to hormone therapy develops, and cumulative toxicity, comorbidities, performance status, and prior adjuvant therapy influence the next step for treatment. Due to all of these factors, finding an effective, well-tolerated treatment can be difficult. However, results from a phase 3 clinical trial, published in the European Journal of Cancer, reveal that scientists are a step closer to this goal: eribulin (Halaven®, Eisai Inc.) monotherapy has been shown to be a safe and effective treatment for individuals with heavily pretreated recurrent/metastatic breast cancer.
In this open-label study, 530 patients with locally recurrent/metastatic breast cancer who had previously been treated with two to five chemotherapy regimens were randomized in a 1:1 ratio to receive either 1.4 mg/m2 of eribulin intravenously on days 1, 8, and 15 of every 21 day-cycle or 25 mg/m2of vinorelbine intravenously on days 1, 8, and 15 of every 21-day cycle. Compared with vinorelbine, eribulin improved overall response rate (30.7% vs 16.9%) and overall survival (13.4 vs 12.5 months). Patients who received eribulin had a 20% risk reduction in progression events; however, the median progression-free survival was 2.8 months in both study arms.
Fewer women discontinued taking eribulin (7.2%) due to treatment-related adverse events compared with vinorelbine (14.0%). Grade 3 and greater side effects occurred in 90.2% of eribulin-treated patients. The most common adverse events were a decrease in both white blood cell count and neutrophil count. Almost a quarter of all eribulin-treated patients experienced asthenia and/or pyrexia of any grade. Despite these adverse events, the investigators believe that eribulin is a safe and effective option for women with heavily pretreated recurrent/metastatic breast cancer.
The study authors conclude, "Taken with evidence of reduced toxicity, the current study supports the use of eribulin in women with recurrent/[metastatic breast cancer] who have previously received an anthracycline and a taxane."
For More Information
Clinicaltrials.gov (2019). Eribulin versus vinorelbine in subjects with locally recurrent or metastatic breast cancer previously treated with anthracyclines and taxanes. NLM identifier: NCT02225470.
Yuan P, Hu X, Sun T, et al (2019). Eribulin mesilate versus vinorelbine in women with locally recurrent or metastatic breast cancer: a randomized clinical trial. Eur J Cancer. 112:57-65. DOI:10.1016/j.ejca.2019.02.002
Image Courtesy of Ed Uthman