Eribulin monotherapy in a patient with heavily pretreated metastatic breast cancer: Case study and review of the literature

Abstract

Treatment of heavily pretreated patients with metastatic breast cancer is challenging due to the combination of progressive disease and limited treatment options. As breast cancer in this setting is no longer curable, treatment goals include improvement/maintenance of quality of life, reduction of tumor-related symptoms, and prolonged survival. In the current review we discuss treatment options in late-line metastatic breast cancer, including newer chemotherapeutic agents such as eribulin, a recently approved non-taxane microtubule dynamics inhibitor whose mechanism of action is distinct from that of other tubulin-targeting agents. We also report on a 42-year-old woman with invasive ductal carcinoma (T4 N1 M1), positive for estrogen and progesterone receptors and negative for HER2, who had been heavily pretreated with radiation (to the bone metastases), hormonal therapy, and multiple systemic cytotoxic therapies-including a nanoparticle albumin-bound paclitaxel/bevacizumab/gemcitabine combination, and pegylated liposomal doxorubicin-none of which lasted for more than 4 months (due to progressive disease or toxicity). Upon receiving eribulin (in a clinical trial setting), she remained in stable disease for 21 months and generally tolerated eribulin well (except for thrombocytopenia, which resulted in mild, non-life-threatening gastrointestinal bleeding and was resolved with a dose reduction). This case is consistent with findings from phases 2 and 3 of eribulin in the setting of heavily pretreated metastatic breast cancer. It is discussed in the context of the current treatment goals and treatment modalities in the late-line metastatic breast cancer setting.