J Cancer 2019; 10(24):5903-5914. doi:10.7150/jca.35109

Review

Eribulin in Triple Negative Metastatic Breast Cancer: Critic Interpretation of Current Evidence and Projection for Future Scenarios

Laura Pizzuti1, Eriseld Krasniqi1, Giacomo Barchiesi1, Marco Mazzotta2, Maddalena Barba1,✉, Antonella Amodio1, Gioia Massimiani1, Fabio Pelle3, Ramy Kayal4, Enrico Vizza5, Antonino Grassadonia6, Silverio Tomao7, Aldo Venuti8, Teresa Gamucci9, Paolo Marchetti2, Clara Natoli6, Giuseppe Sanguineti10, Gennaro Ciliberto11, Patrizia Vici1

1. Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy.
2. Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea, 00189 Rome, Italy.
3. Department of Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
4. Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
5. Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
6. Department of Medical, Oral & Biotechnological Sciences University G. D'Annunzio, Chieti-Pescara, Italy
7. Department of Radiological, Oncological and Anatomo-Pathological Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, I-00161 Rome, Italy
8. HPV-Unit-UOSD Tumor Immunology and Immunotherapy, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, Italy.
9. Medical Oncology, Sandro Pertini Hospital, Rome, Italy.
10. Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
11. Scientific Direction , IRCCS Regina Elena National Cancer Institute , Via Elio Chianesi 53, 00144, Rome, Italy.

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Citation:
Pizzuti L, Krasniqi E, Barchiesi G, Mazzotta M, Barba M, Amodio A, Massimiani G, Pelle F, Kayal R, Vizza E, Grassadonia A, Tomao S, Venuti A, Gamucci T, Marchetti P, Natoli C, Sanguineti G, Ciliberto G, Vici P. Eribulin in Triple Negative Metastatic Breast Cancer: Critic Interpretation of Current Evidence and Projection for Future Scenarios. J Cancer 2019; 10(24):5903-5914. doi:10.7150/jca.35109. Available from http://www.jcancer.org/v10p5903.htm

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Abstract

Triple negative breast cancer (TNBC) is characterized by distinctive biological features that confer an aggressive clinical behavior. In TNBC patients, the absence of well-defined driver pathways such as hormonal receptor expression or hyperactivation of the human epidermal growth factor receptor 2 (HER2) significantly reduce the spectrum of therapeutic options, which are currently mainly confined to chemotherapy. Thus far, median overall survival for patients with metastatic TNBC is about 9-12 months with conventional cytotoxic agents. However, the heterogeneity recently revealed at a gene expression level inside the TNBC family may help inform therapeutic decisions concerning the use of chemotherapy and hopefully lead the way to novel targeted options that include immunotherapy. Eribulin, a halichondrin class antineoplastic drug, is currently recommended for treatment of HER2 negative metastatic or recurrent breast cancer (BC) previously exposed to anthracyclines and taxanes, also for patients with a TNBC. It is currently indicated from the second line of treatment. In this review, we aim to analyze a wide range of cumulated evidence on eribulin use in TNBC including preclinical studies, intervention and observational clinical trials. Data from the real-world setting and the emerging evidence increasingly substantiating the rationale for combinations with new generation treatment strategies, e.g., PARP-inhibitors, immune checkpoint inhibitors, will be also discussed.

Keywords: eribulin, triple negative subtype, metastatic breast cancer