Eribulin is a novel microtubule poison, which has certain advantages as compared to taxanes in some laboratory experiments and shows clinical efficacy in breast cancer patients after failure of taxane and anthracycline treatment. Promising activity of neoadjuvant eribulin plus carboplatin combination was shown in previous TNBC studies [Kaklamani et al. Breast Cancer Res Treat, 2015]. This investigation aimed to directly compare the efficacy of neoadjuvant eribulin/carboplatin vs. paclitaxel/carboplatin doublets in TNBC patients.
61 TNBC patients (median age 45, range 31-76) were randomized to receive carboplatin AUC6 with either eribulin (1.1 mg/m2 on days 1 and 8, every three weeks) or paclitaxel (80 mg/m2 on days 1 and 8, every three weeks). Each patient was treated with four cycles of neoadjuvant therapy followed by surgery and four cycles of adjuvant FAC (5-fluorouracil 500 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2). After adjuvant chemotherapy, patients with breast-conserving surgery or with positive lymph nodes also received radiation treatment.
The rates of clinical complete responses were similar in both cohorts (eribulin/carboplatin: 12/24 (50%); paclitaxel/carboplatin: 19/37 (51%)). Pathologic complete responses (pCR) were numerically less frequent in patients receiving eribulin [9/24 (38%) vs. 20/37 (54%)], although the difference was below statistical significance (p = 0.2). Five patients were carriers of deleterious BRCA1 alleles; pCRs were observed in 2/3 (67%) and 2/2 (100%) women in eribulin and paclitaxel arms, respectively. 56 patients had a follow-up above 12 months at the time of data analysis. 4/24 (17%) disease recurrences were documented in the eribulin arm, while only 1/32 (3%) TNBC relapse was noticed for paclitaxel (p = 0.15).
Eribulin plus carboplatin combination does not outperform, in terms of pathomorphological response to treatment, paclitaxel plus carboplatin doublet while given as a neoadjuvant treatment for triple-negative breast cancer.
Petrov's National Medical Research Center for Oncology.
Russian Science Foundation [grant number 14-25-00111].
All authors have declared no conflicts of interest.