First-line bevacizumab and eribulin combination therapy for HER2-negative metastatic breast cancer: Efficacy and safety in the GINECO phase II ESMERALDA study

Hardy‐Bessard, Anne‐Claire; Brocard, Fabien; Clatot, Florian; Lortholary, Alain; You, Benoît; Grenier, Julien; Martin-Babau, J.; Lucas, B.; Meunier, Jérôme; Ferrero, Jean-­Marc; Savoye, Aude-Marie; Marti, Adina; Despax, Raymond; Moullet, Isabelle; Emile, George

doi:10.1016/j.breast.2020.09.011

Cited by 10 publications

(13 citation statements)

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“…Recent studies have focused on the combination of eribulin and targeted agents, including anti-HER2 agents, 23 poly ADP-ribose polymerase inhibitors, 24 immune checkpoint inhibitors, 25 and anti-angiogenesis agents. 26 Investigators have applied these novel combinations in patients in clinical practice, based on tumor subtypes and gene signatures. More than one-fifth of patients treated with the combination of eribulin and bevacizumab showed prolonged PFS compared to those treated with eribulin monotherapy; a similar conclusion was reached in the E2100 trial of paclitaxel plus bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

Real-world effectiveness of eribulin in heavily pretreated patients with metastatic breast cancer in China: a multicenter retrospective study

Zhao

Xie

et al. 2021

Ther Adv Med Oncol

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Background: Eribulin is a nontaxane microtubule inhibitor approved in China for patients with advanced breast cancer who show progression after ⩾2 lines of chemotherapy. The aim of this study was to determine the efficacy and safety profile of eribulin and explore potential predictive factors for the efficacy of eribulin among Chinese women with metastatic breast cancer (MBC) in real-world practice. Patients and Methods: A total of 272 consecutive MBC patients who were treated with eribulin between November 2019 and October 2020 in 9 institutions nationwide were included in this study. Eribulin was administered intravenously at a dose of 1.4 mg/m2 on days 1 and 8 of a 21-day cycle. Efficacy outcomes included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and clinical benefit rate (CBR). Adverse events (AEs) were graded according to The National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 5.0. Results: Eribulin showed a median PFS of 4.1 months (95% confidence interval [CI] 3.6–4.6); however, the OS data were immature. The ORR was 17.6% and the CBR was 24.6%. A total of 51.8% of patients received eribulin monotherapy, while 48.2% of patients were treated with eribulin plus targeted therapy or other chemotherapy. The number of metastatic sites, duration of previous taxane treatment for MBC, and combination with bevacizumab were significant in Cox multivariate analysis ( p = 0.023, p = 0.048, and p = 0.046, respectively) and were significantly associated with PFS of eribulin. The most common AEs with eribulin treatment were hematological toxicities, including neutropenia, leukopenia, and anemia. Conclusion: Eribulin was effective with a manageable toxicity profile in clinical practice. Furthermore, when prescribed in combination with other agents, eribulin did not increase the toxic effects of each agent. Eribulin monotherapy or plus other agents is an alternative for the heavily pretreated patients with MBC.

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Section: Discussionmentioning

confidence: 99%

Real-world effectiveness of eribulin in heavily pretreated patients with metastatic breast cancer in China: a multicenter retrospective study

Zhao

Xie

et al. 2021

Ther Adv Med Oncol

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“…Since then, eribulin has been investigated in combination with various targeted drugs including antiangiogenic agents, anti-HER2 agents and immune checkpoint inhibitors and other chemotherapeutic agents. 21,22 In this real-world study, we demonstrated the effectiveness and safety of eribulin-based therapy in heavily pretreated Chinese patients and provided data on the impact on QoL of eribulin-based therapy.…”

Section: Discussionmentioning

confidence: 86%

Effectiveness, safety, and impact on quality of life of eribulin‐based therapy in heavily pretreated patients with metastatic breast cancer: A real‐world analysis

Gui

Liang

2023

Cancer Medicine

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IntroductionEribulin is currently recommended for the treatment of patients with metastatic breast cancer (MBC) pre‐treated with taxanes and anthracyclines. The aim of the present study was to evaluate the effectiveness and safety of eribulin and its impact on health‐related quality of life in heavily pre‐treated patients with MBC.MethodsData from MBC patients who had received eribulin‐based therapy at Beijing Cancer Hospital between January 2020 and July 2022 were analyzed retrospectively. Progression‐free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), adverse effects (AEs) and health‐related quality of life (HRQoL) were assessed.ResultsData from 118 patients who had received eribulin to treat MBC were included. Median PFS was 4.2 months and median OS had not been reached. The ORR was 13.6% (16/118) and DCR was 75.4% (89/118). The median PFS in patients who received eribulin in second‐line (26/118), third‐line (29/118), or fourth‐line or later (63/118) was 4.5, 4.2, and 3.9 months, respectively. The median OS in patients who received eribulin in third‐ or later line (n = 92) was 14.1 months. Patients who received eribulin combination therapy had a significantly longer median PFS compared with those who received eribulin monotherapy (4.5 vs. 3.4 months, p = 0.007) and there was a trend towards a longer median OS (not reached vs. 12.1 months). The most common grade 3–4 adverse events were neutropenia (22.9%), leukocytopenia (13.6%) and asthenia/fatigue (8.5%), without significant differences in safety between eribulin monotherapy and combination therapy. Quality of life was similar in patients who received eribulin monotherapy and combination therapy, except for cognitive function and nausea and vomiting symptoms, which were better with combination therapy.ConclusionsThe present study suggests that eribulin‐based therapy is an effective treatment option and well tolerated for heavily pre‐treated patients with MBC. Eribulin combination therapy might improve PFS and HRQoL compared with eribulin monotherapy.

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“…Currently, most studies of bevacizumab on MBC are aimed at first-line treatment [ 20 , 21 , 22 , 23 , 24 , 25 ]. Three classic phase 3 studies have shown that compared with chemotherapy alone, bevacizumab combined with chemotherapy as first-line treatment can significantly prolong the PFS of MBC patients but fails to improve the OS [ 10 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Bevacizumab in Pretreated Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

Guo

Wang

et al. 2022

Oncol Res Treat

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Background: The use of bevacizumab in patients with previously treated metastatic breast cancer (MBC) is controversial. This meta-analysis was carried out to evaluate the efficacy and safety of the regimen including bevacizumab among patients with pretreated MBC. Methods: We systematically searched PubMed, the Cochrane Library, Web of Science, and Embase databases for randomized controlled trials evaluating bevacizumab combined with chemotherapy for previously treated MBC patients. The primary endpoints were progression-free survival (PFS) and objective response rate (ORR). The secondary endpoints were overall survival (OS) and toxicity. The risk of bias was assessed by the Cochrane Collaboration’s tool. The pooled hazard ratio (HR) and risk ratio (RR) with 95% confidence intervals (CIs) were calculated for the identified studies. This study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results: Four studies involving 1,640 individuals were included. Pooling results showed that the PFS of bevacizumab-containing groups (HR 0.82; 95% CI 0.73–0.93, p = 0.002) was significantly better than that of the control groups, especially when bevacizumab was administered as the second-line treatment for patients with human epidermal growth factor receptor 2 (HER2)-negative MBC (HR 0.77; 95% CI 0.66–0.88, p = 0.0002). The ORR in the bevacizumab-containing group was superior to that in the control group, both in the general (RR 1.45; 95% CI 1.18–1.78, p = 0.0004) and HER2-negative groups (RR 1.30; 95% CI 1.03–1.63, p = 0.03). However, no significant effect on OS was demonstrated for the addition of bevacizumab to the second-line treatment for HER2-negative MBC (HR 0.93; 95% CI 0.79–1.10, p = 0.39). Comparatively, proteinuria was more common in the bevacizumab-containing group. In addition, the application of bevacizumab tended to result in therapy discontinuation due to treatment-related toxicity. Conclusions: Bevacizumab-containing chemotherapy, in light of its favorable effects on clinical outcomes, could be a preferred therapeutic option for patients with MBC, for whom the disease must be rapidly relieved. Further studies are warranted for exploring the advantageous patients with the receipt of bevacizumab in multiline treatment.

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First-line bevacizumab and eribulin combination therapy for HER2-negative metastatic breast cancer: Efficacy and safety in the GINECO phase II ESMERALDA study

Cited by 10 publications

References 34 publications

Real-world effectiveness of eribulin in heavily pretreated patients with metastatic breast cancer in China: a multicenter retrospective study

Real-world effectiveness of eribulin in heavily pretreated patients with metastatic breast cancer in China: a multicenter retrospective study

Effectiveness, safety, and impact on quality of life of eribulin‐based therapy in heavily pretreated patients with metastatic breast cancer: A real‐world analysis

Efficacy and Safety of Bevacizumab in Pretreated Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

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