December 13, 2016

Eribulin/Pertuzumab Combo Useful for Treatment of Taxane-Resistant Advanced Breast Cancer

By Brian Hoyle

SAN ANTONIO, Tex -- December 13, 2016 -- Eribulin in combination with pertuzumab and trastuzumab could be a useful therapy for human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer previously treated using taxane.

The findings were presented on December 9 at the 39th Annual San Antonio Breast Cancer Symposium (SABCS) by Kazuhiro Araki, MD, Cancer Institute Hospital, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan.

The single-institute, single-arm, open-label, phase 2 trial enrolled patients aged 20 years and older with HER2-positive advanced breast cancer who had been previously treated with taxanes and trastuzumab.

The most prevalent sites of metastases were lymph nodes, bone, skin, and lungs. Exclusion criteria included central nervous system metastases, systemic infectious disease, cardiovascular difficulties, and uncontrolled medical conditions.

Patients received pertuzumab (loading dose of 840 mg followed by 420 mg every 3 weeks) and trastuzumab (8 mg/kg loading dose with maintenance dose of 6 mg/kg every 3 weeks). Eribulin 1.4 mg/m2 was given intravenously on day 1 and 8 of each 21-day cycle, with 2 reductions in dose allowed as necessary. The cycles were continued until disease progression or unacceptable toxicity.

The overall median progression-free survival (PFS) was 42.6 weeks. Median PFS was 45.6 weeks in 23 patients who had not been treated before, but only 19.1 weeks in 7 previously-treated patients.

Complete response was not evident. Partial response was evident in 34.8% of patients, with disease stable for up to 6 months in the same percentage and for a longer time in 26.1%.

The treatment was well tolerated and no new safety signals were observed. The most common adverse event (AE) was neutropenia in 27 patients (90%). Grade 3 neutropenia was noted in 15 patients (50.0%) and grade 4 in 5 patients (16.7%). Febrile neutropenia was not evident. Grade 1/2 AEs included fatigue (80%), anorexia (76.7%), anaemia (73.3%), diarrhoea (66.7%), peripheral neuropathy (53.3%), and hand-foot syndrome (43.3%).

One patient had asymptomatic left ventricular ejection fraction decrease. Otherwise, there was no overall decrease in mean left ventricular ejection fraction from baseline.

[Presentation title: Eribulin Should Be a Candidate Strategy in Combination With Pertuzumab Plus Trastuzumab for Taxane Pre-Treated HER2-Positive Advance Breast Cancer. Abstract P5-15-11]

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