PR88 EXPERIENCE WITH ERIBULIN IN THE TREATMENT OF METASTATIC BREAST CANCER IN TATARSTAN REPUBLIC CLINICAL ONCOLOGICAL DISPENSARY

Abstract

Background: Disseminated breast cancer is chronic systemic disease that requires long-term personalized drug therapy with rapidly alternating regimens. Eribulin routinely practiced in Russia since 2013 can increase the life expectancy of such patients, effectively blocked tumor growth. Material and Methods: 7 patients received eribulin from March 2014 to March 2015. The average age was 53 years old. All patients had already got from 1 to 3 lines of chemotherapy due to metastatic disease. Three patients received eribulin as second-line therapy, another three in the third line therapy, one patient in the fourth line of therapy. Three patients had hormone-positive breast cancer, 3 patients were HER2 neu positive, 4 patients had HER2-negative tumors (two of them were triple-negative). All patients previously received anthracyclines and taxanes. Patients received eribulin in monotherapy, 6 patients received a dose of eribulin mezylate 1.4 mg/m 2, and 1 patient initially received a reduced dose of the drug in 1.1 mg/m2 due to increased liver enzymes after previous treatment. Eribulin was administered in the 1st and 8th days of a 21 day cycle IV bolus. Evaluation of the effect was based on physical examination and CT scan every 6-8 weeks. All patients were treated until disease progression. Results: Six patients have visceral metastases, one patient had local recurrence in the area of operation and remote lymph nodes. Liver lesions were in 4 patients, lung lesions in three patients, in three patients there were bone metastases. Most patients had multiple combined lesions, only 1 patient had isolated lung metastases. One patient had combined lung, liver and brain metastases. All patients received 3 to 14 cycles of eribulin, the median duration of therapy was 16 weeks. Survival to progression ranged from 3 to 10 months, the median progression-free survival was 5.5 months. This 10-month disease-free period was observed in patients who received eribulin as chemotherapy 4th line (thus the maximal duration of effect of other chemotherapy drugs in earlier lines of treatment should not exceed 6 months). In 2 patients, including patient with brain metastases, achieved stable disease, treatment is ongoing. Most common adverse events were hematological and hepatological: leukopenia, neutropenia, increased ALT, AST, headache. Maximal toxicity was grade 2 (according to the criteria STCAE 4.0). No serious adverse effects during treatment with eribulin were observed. Conclusions: Eribulin provides a significant effect in patients with metastatic breast cancer when used in the 2nd and the following lines of chemotherapy. Side effects of therapy usually do not lead to drug discontinuation and easily stopped, without compromising the quality of life of patients.