Prognostic Factors for Long-Term Eribulin Response in a Cohort of Patients With HER2-Negative Metastatic Breast Cancer

Clin Breast Cancer. 2024 Oct;24(7):e622-e632.e5. doi: 10.1016/j.clbc.2024.06.006. Epub 2024 Jun 19.

Abstract

Context and aims: Eribulin is used in taxane and anthracycline refractory HER2-negative metastatic breast cancers (MBC). Patients treated in pivotal clinical trials achieved low survival rates, therefore, the identification of prognostic criteria for long progression-free survival (PFS) is still an unmet medical need. In this study, we sought to determine potential prognostic criteria for long-term eribulin response in HER2-negative MBC.

Methods: Our retrospective cohort includes female patients with HER2-negative MBC treated with eribulin in Franche-Comté, France. We defined a long-term response as at least 6 months of eribulin treatment. The primary endpoint was the analysis of criteria that differ according to the progression-free survival. Secondary outcomes concerned overall survival and response rate.

Results: From January 2011 to April 2020, 431 patients treated with eribulin were screened. Of them, 374 patients were included. Median PFS was 3.2 months (2.8-3.7). Eighty-eight patients (23.5%) had a long-term response to eribulin. Four discriminant criteria allowed to separate PFS in 2 arms (PFS < 3 months or > 6 months) with a 78% positive predictive value: histological grade, absence of meningeal metastasis, response to prior chemotherapy, and OMS status. We have developed a nomogram combining these 4 criteria. Median overall survival was 8.5 months (7.0-9.5).

Conclusion: Eribulin response in MBC can be driven by clinical and biological factors. Application of our nomogram could assist in the prescription of eribulin.

Keywords: Eribulin; MDM2; Metastatic breast cancer; long response; nomogram.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / metabolism
  • Breast Neoplasms* / mortality
  • Breast Neoplasms* / pathology
  • Female
  • France
  • Furans* / therapeutic use
  • Humans
  • Ketones* / therapeutic use
  • Middle Aged
  • Polyether Polyketides
  • Prognosis
  • Progression-Free Survival
  • Receptor, ErbB-2* / metabolism
  • Retrospective Studies
  • Survival Rate

Substances

  • eribulin
  • Ketones
  • Furans
  • Receptor, ErbB-2
  • ERBB2 protein, human
  • Antineoplastic Agents
  • Polyether Polyketides