Effectiveness and safety of eribulin mesylate: a new therapeutic option in the treatment of metastatic breast cancer

Coyne, Geraldine Helen O'Sullivan; Walsh, Janice; Kelly, Catherine M.

doi:10.1517/14740338.2012.698608

Cited by 7 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common adverse effects observed in both the treatment arms were asthenia (or fatigue) and neutropenia, most of which were Grade 1 or 2. [44,45] Grade 3 or 4 events that were more frequent in the eribulin group than in the TPC group were leukopenia, neutropenia, and peripheral neuropathy. There was more myelosuppression with eribulin, incidence of Grade 3 or 4 neutropenia being 45% versus 21%; majority of these were asymptomatic.…”

Section: Adverse Effectsmentioning

confidence: 99%

Eribulin mesylate: A new therapeutic option for metastatic breast cancer

Aditya

2013

J Basic Clin Reprod Sci

View full text Add to dashboard Cite

More than a million women are diagnosed with breast cancer annually worldwide. Death from breast cancer is usually a result of chemotherapy-resistant metastatic disease. Eribulin mesylate is a recent addition to the therapeutic armamentarium for treating locally advanced or metastatic breast cancer (MBC) in patients who have received at least two prior chemotherapy regimens for late-stage disease. This synthetic analog, derived from a marine sponge macrolide halichondrin B, inhibits microtubule stability by blocking microtubule growth without affecting microtubule shortening. The US Food and Drug Administration has approved eribulin mesylate as a third-line treatment for MBC refractory to anthracyclines and taxanes based on a Phase III clinical trial showing significantly increased overall survival compared to treatment of investigator's. Asthenia, fatigue, neutropenia, alopecia, nausea, anorexia, and neuropathy are the most frequent adverse effects associated with this drug. The aim of this review was to highlight the importance of this drug in the management of breast cancer. Medline, Excerpta Medica database, cochrane database, medscape, Elsevier Scopus, and clinicaltrials.gov were searched using terms "eribulin," "E7389," "halichondrin," "metastatic breast cancer." Journal articles published from 2007 to 2012 discussing pharmacology and/or clinical trials were screened. The development of this microtubule inhibitor helps to address the need for additional effective regimens for patients progressing after standard treatment with anthracycline-and taxane-containing regimens.

show abstract

Section: Adverse Effectsmentioning

confidence: 99%

Eribulin mesylate: A new therapeutic option for metastatic breast cancer

Aditya

2013

J Basic Clin Reprod Sci

View full text Add to dashboard Cite

show abstract

“…Recently, various agents including antitubulins (eg, vinorelbine, 5 , 6 ixabepilone, 7 and eribulin 8 ), antimetabolites (eg, capecitabine 9 , 10 and gemcitabine 11 , 12 ), topoisomerase I inhibitors (eg, irinotecan 13 ), and platinum analogs (eg, cisplatin 14 ) have been evaluated for their efficacy and safety in this setting when used either alone or in combination with other cytotoxic agents. Compared with single agent, some studies found that doublet agents could gain additional clinical benefits including progression-free survival (PFS), overall survival (OS), and overall response rate (ORR), 7 , 11 which could offer an option for women with anthracycline-and taxane-pretreated MBC.…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of combination therapy versus single-agent therapy in anthracycline- and taxane-pretreated metastatic breast cancer: results from nine randomized Phase III trials

Chun

et al. 2016

OTT

View full text Add to dashboard Cite

Nowadays, the philosophy of treating metastatic breast cancer (MBC) is slowly evolving. Especially for the anthracycline- and taxane-pretreated MBC patients, no standard therapy exists in this setting. Whether to choose doublet agents or single agent as salvage treatment remains fiercely debated. Thus, we conducted a meta-analysis to resolve this problem. Databases including PubMed, EMBASE, and Cochrane library were searched for Phase III randomized clinical trials (published before August 2015) comparing the efficacy and adverse effects between the combination therapy and single-agent therapy in anthracycline- and taxane-pretreated MBC patients. The primary end point was the overall survival (OS), and the secondary end points were the progression-free survival (PFS), overall response rate (ORR), and grade 3 or 4 toxicities. The pooled hazard ratio (HR) and pooled risk ratio (RR) were used to evaluate the efficacy. Analyses were also performed to estimate the side effects and safety of both groups. In all, nine eligible randomized clinical trials were included in this meta-analysis. Improvements were proven in the doublet agents group on OS (HR 0.90, 95% confidence interval [CI] 0.84–0.96, P=0.002), PFS (HR 0.81, 95% CI 0.76–0.88, P<0.001), and ORR (RR 1.72, 95% CI 1.34–2.21, P<0.001). Notably, subgroup analysis failed to favor the targeted agent-based combination in terms of OS (HR 1.08, 95% CI 0.89–1.31, P=0.365), PFS (HR 1.09, 95% CI 0.88–1.35, P=0.433), and ORR (RR 1.60, 95% CI 0.69–3.71, P=0.278) compared with single agent. In addition, although more hematological and gastrointestinal toxicities were observed in the doublet agents group, they were acceptable and manageable. Taken together, when compared with single-agent therapy, doublet agents should be considered a treatment option because of the superior efficacy and the manageable safety profile for the prior anthracycline- and taxane-treated MBC patients.

show abstract

Baseline interleukin-6 is a prognostic factor for patients with metastatic breast cancer treated with eribulin

Bun,

Nagahashi,

Kuroiwa

et al. 2023

Breast Cancer Res Treat

View full text Add to dashboard Cite

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.

show abstract

Effectiveness and safety of eribulin mesylate: a new therapeutic option in the treatment of metastatic breast cancer

Cited by 7 publications

References 25 publications

Eribulin mesylate: A new therapeutic option for metastatic breast cancer

Eribulin mesylate: A new therapeutic option for metastatic breast cancer

A meta-analysis of combination therapy versus single-agent therapy in anthracycline- and taxane-pretreated metastatic breast cancer: results from nine randomized Phase III trials

Baseline interleukin-6 is a prognostic factor for patients with metastatic breast cancer treated with eribulin

Contact Info

Product

Resources

About