Clinical Utility of Eribulin Mesylate in the Treatment of Breast Cancer: A Chinese Perspective

Abstract

Eribulin mesylate, a synthetic derivative of the anti-mitotic agent halichondrin B, has a unique tubulin-based mechanism of action that is distinct from other anti-microtubule agents including taxanes and vinca alkaloids. Consistent with this unique activity, eribulin has shown clinical efficacy in patients with metastatic breast cancer (MBC) that progressed following prior taxane and anthracycline therapy. The evidence presented in this review indicates that eribulin represents a treatment option for patients with HER2-negative metastatic breast cancer. Improved survival outcomes and better tolerability compared with vinorelbine supported the first approval of eribulin in China in 2019; eribulin was approved for women with locally advanced/metastatic HER2-negative breast cancer after treatment failure with at least two chemotherapy regimens, including an anthracycline and a taxane. Eribulin has also shown promising efficacy in patients with HER2-positive advanced breast cancer when used in combination with trastuzumab or pertuzumab, and subgroup analyses from the Phase III clinical trials support the continued evaluation of eribulin in patients with triple-negative disease. The unique non-mitotic effects of eribulin, including vascular remodeling, coupled with its clinical efficacy and safety profile, may permit the broader use of this agent in patients with MBC.

Marine Natural Products in Clinical Use

“…Manageable adverse events were common in patients receiving both treatments, except for peripheral neuropathy observed in the eribulin treatment group, which resulted in the discontinuation of treatment in 5% (of 503 patients) of the patients [ 115 , 116 ]. EM was initially approved for patients with HER2-negative metastatic breast cancer, but it was also shown to lead to an effective clinical outcome for HER2-positive patients, indicating a broader use of the drug in the future [ 111 , 117 ].…”

Ircinia ramosa Sponge Extract (iSP) Induces Apoptosis in Human Melanoma Cells and Inhibits Melanoma Cell Migration and Invasiveness

“…Extracts from Haliclona (Soestella) mucosa (Griessinger, 1971), a Mediterranean sponge, was found to induce a cytotoxic effect and apoptosis in A375 human malignant melanoma cell line when used in combination with doxorubicin [41]. Halichondrin-B is a cytotoxin isolated from the sponge, Halichondria (Halichondria) okadai (Kadota, 1922), and it is known for its analogue, eribulin mesylate, which was approved by FDA in 2011 for the treatment of metastatic breast cancer [42]. However, Halichondrin-B demonstrated excellent preclinical activity in vivo by using different murine xenograft models of human cancer, such as colon cancer, glioblastoma, head and neck cancer, small-cell lung cancer and melanoma models [7,43].…”

A review of FDA approved drugs and their formulations for the treatment of breast cancer

“…It can be moderately well tolerated when administered orally once every day in daily doses of 1,250 mg-1,500 mg for 1-21 days. Gastrointestinal complications and skin rashes are the main toxicities observed in more than 20% of patients consuming Lapatinib (Yuan and Xu, 2021). It has been reported that Lapatinib is well accepted in patients who are resistant to Trastuzumab.…”