Department of Breast and Endocrine Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Department of Breast Surgery, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashi-machi, Kawachinagano City, Osaka, 586-8521, Japan.
Cancer Chemother Pharmacol. 2018 May;81(5):923-933. doi: 10.1007/s00280-018-3567-y. Epub 2018 Mar 28.
Although eribulin is a suitable option for early-line treatment of metastatic breast cancer (MBC), data on first- or second-line use of eribulin for human epidermal growth factor receptor 2 (HER2)-negative MBC are still limited. Therefore, we conducted a phase II trial to investigate the efficacy and safety of eribulin for first- or second-line chemotherapy for HER2-negative MBC.
We performed a phase II, open-label, single-arm, multicenter study in Japan. Eligible patients were women with histologically confirmed HER2-negative MBC without chemotherapy or only one chemotherapy line for MBC. The primary endpoint was the overall response rate (ORR) and the secondary endpoints included the clinical benefit rate (ORR + stable disease for 6 months; CBR), progression-free survival (PFS), overall survival (OS), duration of response (DOR), safety, and health-related quality of life (HRQoL).
A total of 35 patients with HER2-negative MBC were enrolled between March 2013 and February 2017 (data cut-off July 31, 2017). The ORR was 37.1% (95% CI 21.1-53.2%). The CBR was 54.3% (95% CI 37.8-70.8%). The median PFS was 6.2 months (95% CI 2.7-9.4 months) and median OS was 21.4 months (95% CI 11.5-32.9 months). Common grade 3/4 adverse events were neutropenia (42.9%) but febrile neutropenia (2.9%). Although the majority of non-hematological adverse events were mild in severity, one patient died of pneumonitis. In HRQoL analysis, eribulin appeared to maintain HRQoL of many patients.
Eribulin as first- or second-line chemotherapy is effective and has manageable toxicity for patients with HER2-negative MBC.
尽管表柔比星是转移性乳腺癌(MBC)一线治疗的合适选择,但对于 HER2 阴性 MBC 的一线或二线使用表柔比星的数据仍有限。因此,我们进行了一项 II 期临床试验,以研究表柔比星作为 HER2 阴性 MBC 的一线或二线化疗的疗效和安全性。
我们在日本进行了一项 II 期、开放标签、单臂、多中心研究。符合条件的患者为组织学证实的 HER2 阴性 MBC 女性,无化疗或仅接受过一线 MBC 化疗。主要终点是总缓解率(ORR),次要终点包括临床获益率(ORR+稳定疾病持续 6 个月;CBR)、无进展生存期(PFS)、总生存期(OS)、缓解持续时间(DOR)、安全性和健康相关生活质量(HRQoL)。
共有 35 名 HER2 阴性 MBC 患者于 2013 年 3 月至 2017 年 2 月(数据截止日期为 2017 年 7 月 31 日)入组。ORR 为 37.1%(95%CI 21.1-53.2%)。CBR 为 54.3%(95%CI 37.8-70.8%)。中位 PFS 为 6.2 个月(95%CI 2.7-9.4 个月),中位 OS 为 21.4 个月(95%CI 11.5-32.9 个月)。常见的 3/4 级不良事件是中性粒细胞减少(42.9%),但发热性中性粒细胞减少症(2.9%)。尽管大多数非血液学不良事件的严重程度为轻度,但有 1 例患者死于肺炎。在 HRQoL 分析中,表柔比星似乎维持了许多患者的 HRQoL。
表柔比星作为一线或二线化疗对 HER2 阴性 MBC 患者有效且毒性可管理。