Prospects of eribulin administration for patients with HR-positive HER2-negative metastatic breast cancer after progression on CDK4/6 Inhibitors: theoretical background and first experience

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  • Authors: Kolyadina I.V.1, Ganshina I.P.2, Kuzmicheva S.V.3, Tekeeva A.I.4, Kolokolov J.D.5, Volkonskii M.V.6, Poddubnaya I.V.1
  • Affiliations:
    1. Russian Medical Academy of Continuous Professional Education
    2. Blokhin National Medical Research Center of Oncology
    3. Loginov Moscow Clinical Scientific Center
    4. Rehabilitation Medical Center
    5. Botkin City Clinical Hospital
    6. Moscow City Oncological Hospital №62
  • Issue: Vol 22, No 2 (2020)
  • Pages: 98-103
  • Section: Best Practice
  • URL: https://modernonco.orscience.ru/1815-1434/article/view/34960
  • DOI: https://doi.org/10.26442/18151434.2020.2.200212
  • Cite item

Abstract


Combining cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors with endocrine therapies in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer in the first and second lines has emerged as optimal treatment strategy and has implications related to clinical efficacy, rapid clinical response and manageable tolerability. However, approximately one in five women has progression during the first year, we have to make efforts to choose the treatments for hormone receptor-positive breast cancer. Potential treatment options include prospective chemotherapy drug eribulin, its efficacy has been demonstrated in various biological subtypes of metastatic breast cancer in patients pretreated with anthracyclines and taxanes. Data from EMPOWER study evaluating the use of eribulin in female patients with hormone positive HER2-negative metastatic breast cancer who received CDK 4/6 inhibitor therapy showed promising results. In the cohort eribulin was prescribed according to the FDA indications in the USA after at least three prior regimens with a prior anthracycline and a taxane overall response rate was 26.7%, clinical benefit rate was 54.1%, median progressive-free survival was not reached and 6-month progressive-free survival rates was 70.4%. Eribulin demonstrated a manageable tolerability profile, adverse event rates were similar to those in clinical trials and other observational studies. In this paper we present the analysis from Russia of five cases of luminal HER2-negative breast cancer who had progression after CDK 4/6 inhibitor therapy. All patients had visceral metastases, one of them had brain metastases. Eribulin was used according to prescribing information in Russia, in metastatic settings in patients pretreated with anthracyclines and taxanes in the second chemotherapy line (3 patients) and in the third line (2 patients). Four patients achieved stable disease, one patient had partial response. Duration of eribulin treatment response was from 8 to 22 months. Eribulin appeared to be well-tolerated, dose reduction was not noted. Data from EMPOWER (USA) and the first treatment results from Russia demonstrated eribulin may be a potential treatment option in hormone-positive breast cancer following prior CDK 4/6i therapy for disease control and to preserve quality of life.


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About the authors

Irina V. Kolyadina

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: irinakolyadina@yandex.ru
ORCID iD: 0000-0002-1124-6802

Russian Federation, Moscow

MD, PhD, Prof.

Inna P. Ganshina

Blokhin National Medical Research Center of Oncology

Email: irinakolyadina@yandex.ru

Russian Federation, Moscow

Leading Researcher Officer

Svetlana V. Kuzmicheva

Loginov Moscow Clinical Scientific Center

Email: irinakolyadina@yandex.ru

Russian Federation, Moscow

head of the day hospital

Asiiat I. Tekeeva

Rehabilitation Medical Center

Email: irinakolyadina@yandex.ru

Russian Federation, Podolsk

oncologist

James D. Kolokolov

Botkin City Clinical Hospital

Email: irinakolyadina@yandex.ru

Russian Federation, Moscow

chemotherapist

Mikhail V. Volkonskii

Moscow City Oncological Hospital №62

Email: irinakolyadina@yandex.ru
ORCID iD: 0000-0003-4060-5015

Russian Federation, Istra

head of the day hospital

Irina V. Poddubnaya

Russian Medical Academy of Continuous Professional Education

Email: irinakolyadina@yandex.ru
ORCID iD: 0000-0002-0995-1801

Russian Federation, Moscow

D. Sci. (Med.), Prof., Acad. RAS

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Supplementary files

Supplementary Files Action
1.
Fig. 1. The efficacy of eribulin as the 3rd line of chemotherapy in a patient with HR-positive HER2-negative metastatic breast cancer, before the start of an eribulin therapy and after 11 months of the therapy.

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2.
Fig. 2. Metastases in the frontal bone, cerebral membranes with intracranial component (a – before the eribulin therapy, b – after 10 cycles of eribulin).

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