Department of Breast Medical Oncology, Cancer Institute Hospital of JFCR, Tokyo, Japan.
Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Breast Cancer Res Treat. 2023 Oct;201(3):409-415. doi: 10.1007/s10549-023-07030-x. Epub 2023 Jul 22.
Metastatic breast cancer (MBC) is usually incurable; treatment aims to maximize patients' function and quality of life (QOL). Eribulin is a standard treatment in patients with MBC pretreated with anthracycline and taxane; however, the best administration schedule is unknown.
In this prospective phase II trial of patients with luminal MBC, we administered biweekly eribulin to patients who completed a three-cycle induction treatment.
Sixty patients with hormone-receptor-positive and HER2-negative MBC were enrolled; 40 obtained stable disease (SD) or better efficacy after induction therapy, after which they were switched to biweekly maintenance administration. The median progression-free survival (PFS) in patients who switched to maintenance therapy was 15.21 weeks (95% CI 9.71-22.14), starting on the first day of maintenance therapy. Overall survival (OS) in patients who switched to maintenance therapy was 21.39 months (95% CI 18.89-32.89). PFS and OS in the whole population starting from the registration date were 19.00 weeks (95% CI 17.00-25.00) and 21.52 months (95% CI 16.23-24.25), respectively. PFS from the enrollment date for patients who received maintenance therapy was 25.29 weeks (95% CI 19.14-32.14). Patients who achieved complete response or partial response during induction therapy had significantly longer PFS compared to patients with SD.
The efficacy of biweekly administration of eribulin at maintenance was nonsignificant. However, less frequent visits are convenient, and reduced dose intensity improves safety. Biweekly administration, besides dose reduction, could be an acceptable option for patients who are unable to maintain a standard regimen.
转移性乳腺癌(MBC)通常无法治愈;治疗旨在最大限度地提高患者的功能和生活质量(QOL)。表柔比星和紫杉烷预处理后的 MBC 患者的标准治疗是艾立布林;然而,最佳给药方案尚不清楚。
在这项针对激素受体阳性和 HER2 阴性 MBC 患者的前瞻性 II 期试验中,我们对完成三周期诱导治疗的患者给予双周艾立布林。
入组 60 例激素受体阳性和 HER2 阴性 MBC 患者;40 例诱导治疗后获得稳定疾病(SD)或更好疗效,随后转换为双周维持治疗。开始维持治疗的第一天,转换为维持治疗的患者中位无进展生存期(PFS)为 15.21 周(95%CI 9.71-22.14)。转换为维持治疗的患者总生存期(OS)为 21.39 个月(95%CI 18.89-32.89)。从登记日期开始,整个队列的 PFS 和 OS 分别为 19.00 周(95%CI 17.00-25.00)和 21.52 个月(95%CI 16.23-24.25)。接受维持治疗的患者从入组日期开始的 PFS 为 25.29 周(95%CI 19.14-32.14)。在诱导治疗期间获得完全缓解或部分缓解的患者与 SD 患者相比,PFS 显著延长。
维持治疗时双周给予艾立布林的疗效不显著。然而,减少就诊次数更方便,降低剂量强度可提高安全性。除了剂量减少外,双周给药对于无法维持标准方案的患者可能是一种可接受的选择。