AI Article Synopsis

  • The study aimed to evaluate how effective eribulin-based neoadjuvant chemotherapy is for treating patients with triple-negative breast cancer (TNBC).
  • In the trial, patients were divided into two main groups based on specific genetic factors and received different chemotherapy regimens, with the effectiveness measured by the pathologic complete response (pCR) rate and safety outcomes.
  • Results indicated a higher pCR rate in younger patients with certain genetic profiles, and while neurotoxicity was a concern, it was less prevalent in the eribulin-based treatment compared to other regimens.

Article Abstract

Purpose: To investigate clinical usefulness of eribulin-based neoadjuvant chemotherapy in triple-negative breast cancer (TNBC) patients.

Methods: Patients in group A (aged < 65 years with homologous recombination deficiency, HRD, score ≥ 42, or those at any age with germline BRCA mutation, gBRCAm) were randomized to 4 cycles of paclitaxel plus carboplatin (group A1) or eribulin plus carboplatin (group A2), followed by 4 cycles of anthracycline. Patients in group B (aged < 65 years with HRD score < 42, or aged ≥ 65 years without gBRCAm) were randomized to 6 cycles of eribulin plus cyclophosphamide (group B1) or eribulin plus capecitabine (group B2); non-responders to the first 4 cycles of the eribulin-based therapy received anthracycline. Primary endpoint was pCR rate (ypT0-is, ypN0; centrally confirmed). Main secondary endpoint was safety.

Results: The full analysis set comprised 99 patients. The pCR rate was 65% (90% CI, 46%-81%) and 45% (27%-65%) in groups A1 and A2, respectively, and 19% (8%-35%) in both groups B1 and B2. No major difference was seen in secondary endpoints, but peripheral neuropathy incidence was 74% in group A1, whereas it was 32%, 22%, and 26% in groups A2, B1, and B2, respectively.

Conclusions: In patients aged < 65 years with high HRD score or gBRCAm, weekly paclitaxel plus carboplatin and eribulin plus carboplatin followed by anthracycline resulted in a pCR rate of > 60% and > 40%, respectively, suggesting potential usefulness of patient stratification using HRD; pCR tended to be low in patients with HRD-negative tumors. Neurotoxicity was less frequent with the eribulin-based regimen.

Trial Registration: The study has been registered with the University Hospital Medical Information Network Clinical Trials Registry ( http://www.umin.ac.jp/ctr/index-j.htm ) with unique trial number UMIN000023162. The Japan Breast Cancer Research Group trial number is JBCRG-22.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233289PMC
http://dx.doi.org/10.1007/s10549-021-06184-wDOI Listing

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Article Synopsis
  • The study aimed to evaluate how effective eribulin-based neoadjuvant chemotherapy is for treating patients with triple-negative breast cancer (TNBC).
  • In the trial, patients were divided into two main groups based on specific genetic factors and received different chemotherapy regimens, with the effectiveness measured by the pathologic complete response (pCR) rate and safety outcomes.
  • Results indicated a higher pCR rate in younger patients with certain genetic profiles, and while neurotoxicity was a concern, it was less prevalent in the eribulin-based treatment compared to other regimens.
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