Real-world efficacy and safety of eribulin in advanced and pretreated HER2-negative breast cancer in a Spanish comprehensive cancer center.


Journal

BMC pharmacology & toxicology
ISSN: 2050-6511
Titre abrégé: BMC Pharmacol Toxicol
Pays: England
ID NLM: 101590449

Informations de publication

Date de publication:
21 11 2019
Historique:
received: 12 09 2019
accepted: 25 10 2019
entrez: 23 11 2019
pubmed: 23 11 2019
medline: 31 3 2020
Statut: epublish

Résumé

Eribulin improves survival in pre-treated HER2-negative advanced breast cancer (ABC). However, limited data exist on co-morbidities and central nervous system (CNS) efficacy. The purpose of this study was to review eribulin's efficacy and safety in everyday clinical practice with special focus on age, body mass index (BMI) and central nervous system (CNS) activity. An observational study was conducted in a series of HER2-negative ABC patients treated from January'14-December'17 outside a clinical trial. Objective Response Rate (ORR), Progression Free Survival (PFS), Overall Survival (OS), and association of clinical and pathological variables with outcome were evaluated. Ninety-five women were treated with at least one cycle of eribulin. Median age was 57 (33-83), and 18% were obese. Median number of prior chemotherapies for ABC was 3 (2-5) and 76% of patients had visceral metastases, including 21% with CNS involvement. Most tumors were estrogen receptor-positive (79%). ORR and stable disease (SD) at 6 months were 26.2 and 37.5%, respectively. Remarkably, relevant CNS efficacy was observed with eribulin: 20% of patients obtained partial response and 25% SD. Treatment was generally well tolerated and manageable, with 29% grade 3 and 10.9% grade 4 toxicities. Median PFS and OS were 4.1 months (CI95% 3.2-4.9) and 11.1 months (CI95% 9.5-14.7), respectively. Triple-negative disease, > 2organs involved and being younger than 70 years old were independent prognosis factors for worse OS in multivariate analysis. Most patients (75%) progressed in pre-existing metastases sites. In everyday clinical practice, eribulin's efficacy seems similar to pivotal trials. CNS-efficacy was observed. TNBC, > 2 organs involved and being younger than 70 years old were independent prognosis factors for worse OS. Remarkably, less incidence of grade 4-toxicity compared to previous studies was found.

Sections du résumé

BACKGROUND
Eribulin improves survival in pre-treated HER2-negative advanced breast cancer (ABC). However, limited data exist on co-morbidities and central nervous system (CNS) efficacy. The purpose of this study was to review eribulin's efficacy and safety in everyday clinical practice with special focus on age, body mass index (BMI) and central nervous system (CNS) activity.
METHODS
An observational study was conducted in a series of HER2-negative ABC patients treated from January'14-December'17 outside a clinical trial. Objective Response Rate (ORR), Progression Free Survival (PFS), Overall Survival (OS), and association of clinical and pathological variables with outcome were evaluated.
RESULTS
Ninety-five women were treated with at least one cycle of eribulin. Median age was 57 (33-83), and 18% were obese. Median number of prior chemotherapies for ABC was 3 (2-5) and 76% of patients had visceral metastases, including 21% with CNS involvement. Most tumors were estrogen receptor-positive (79%). ORR and stable disease (SD) at 6 months were 26.2 and 37.5%, respectively. Remarkably, relevant CNS efficacy was observed with eribulin: 20% of patients obtained partial response and 25% SD. Treatment was generally well tolerated and manageable, with 29% grade 3 and 10.9% grade 4 toxicities. Median PFS and OS were 4.1 months (CI95% 3.2-4.9) and 11.1 months (CI95% 9.5-14.7), respectively. Triple-negative disease, > 2organs involved and being younger than 70 years old were independent prognosis factors for worse OS in multivariate analysis. Most patients (75%) progressed in pre-existing metastases sites.
CONCLUSION
In everyday clinical practice, eribulin's efficacy seems similar to pivotal trials. CNS-efficacy was observed. TNBC, > 2 organs involved and being younger than 70 years old were independent prognosis factors for worse OS. Remarkably, less incidence of grade 4-toxicity compared to previous studies was found.

Identifiants

pubmed: 31753013
doi: 10.1186/s40360-019-0367-x
pii: 10.1186/s40360-019-0367-x
pmc: PMC6868802
doi:

Substances chimiques

Antineoplastic Agents 0
Furans 0
Ketones 0
ERBB2 protein, human EC 2.7.10.1
Receptor, ErbB-2 EC 2.7.10.1
eribulin LR24G6354G

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

68

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Auteurs

Milana Bergamino Sirvén (MB)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Adela Fernández-Ortega (A)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Agostina Stradella (A)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Idoia Morilla (I)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Catalina Falo (C)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Silvia Vázquez (S)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Roser Castany (R)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Rafael Villanueva (R)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Sabela Recalde (S)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Valentí Navarro Pérez (VN)

Research Unit, Institut Català d'Oncologia-(ICO) L'Hospitalet, Barcelona, Spain.

Miguel Gil-Gil (M)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.

Sonia Pernas (S)

Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain. spernas@iconcologia.net.

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