another microtubule inhibitor for Stage IVs--will check further as to whether her2

[Lani]

status matters

Eribulin Prolongs Survival in Women With Metastatic Breast Cancer
Apr 22 - Eribulin, a nontaxane microtubule dynamics inhibitor, prolongs survival in heavily pretreated women with metastatic breast cancer, according to a report in the April Journal of Clinical Oncology.

"Eribulin is a very active drug with a good toxicity profile," Dr. Linda T. Vahdat from Weill Cornell Medical College, New York, told Reuters Health. "It is a great drug and needs to get approved."

Dr. Vahdat and colleagues evaluated the efficacy and tolerability of eribulin in heavily pretreated women with metastatic breast cancer who had already received anthracycline and a taxane.

The overall objective response rate (all partial responses) was 11.5% in the per protocol group, 13.6% in the intention-to-treat analysis, and 16.5% by investigator assessment, the authors say. Eribulin appeared to show activity across a range of patient subgroups.

Median progression-free survival was 79 days, and median overall survival was 275 days, the authors report. Among the 10 responders in the per protocol group, however, median progression-free survival was 264 days and median overall survival was 560 days.

The incidence of febrile neutropenia was low, and only 5 patients experienced grade 3 peripheral neuropathy. Gastrointestinal adverse effects were generally mild.

Eribulin "is probably as active as the taxanes when used in similar settings (which means it is probably as good as ixabepilone)," Dr. Vahdat said. "I think its big advantage is the near lack of alopecia and low rate of peripheral neuropathy."

"My concern is that if we get too caught up in sequence of administering drug in metastatic breast cancer we can miss an opportunity to have another drug available which ultimately extends the survival in increments (by this I mean the obsession with making sure patients have anthracyclines and taxanes before they administer capecitabine, etc.)," she continued. "As you know, sequence doesn't matter with regard to survival when picking a drug for the treatment of advanced breast cancer, but side effects do."

J Clin Oncol 2009.

[Rich66]

"As you know, sequence doesn't matter with regard to survival when picking a drug for the treatment of advanced breast cancer, but side effects do."

Hmm..didn't know that.

[Ellie F]

I didn't either Rich.
Ellie

[Rich66]

I really wonder if this is the case. If cancer stem cell killing chemos are used up front, you would think that would effect outcome. There are so many combinations, potential synergies and variables, I can't believe there is no difference in sequence. I could, however, certainly believe they don't know what the best sequence is.