Eribulin Mesylate as Third or Subsequent Line Chemotherapy for Elderly Patients with Locally Recurrent or Metastatic Breast Cancer: A Multicentric Observational Study of GIOGer (Italian Group of Geriatric Oncology)-ERIBE

The oncologist

article

Silvana Leo¹  Giovanna Campanella²  Mariangela Ciccarese¹  Caterina Accettura¹  Salvatore Pisconti³  Antonio Rinaldi⁴  Cosimo Brunetti⁴  Mimma Raffaele⁵  Luigi Coltelli⁶  Salvatore Spazzapan⁷  Lucia Fratino⁷  Ermenegildo Arnoldi⁸  Luciana Petrucelli¹  Laura Biganzoli⁹  Lazzaro Repetto^1,10  Zaira Coccorullo^1,10  Saverio Cinieri^1,11  Palma Fedele^1,11  Marina Cazzaniga^1,12  Vito Lorusso^1,13  Agnese Latorre^1,13 

[1] Ospedale Fazzi;IRCCS Ospedale De Bellis;Ospedale San Giuseppe Moscati;Ospedale Civile;Presidio Ospedaliero Sant'Andrea-San Filippo Neri;Ospedale Lotti Azienda USL 5;CRO, Aviano, (PN);Ospedali Riuniti di Bergamo;Nuovo Ospedale di Prato;Ospedale Civile Borea;Ospedale Perrino;Ospedale San Gerardo;Istituto Tumori Giovanni Paolo II

关键词: Eribulin mesylate;    Metastatic breast cancer;    Elderly;    Health-related quality of life;    Comprehensive geriatric assessment;   

DOI  :  10.1634/theoncologist.2017-0676

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background Metastatic breast cancer (MBC) is highly prevalent in middle-aged or elderly patients. Eribulin is a nontaxane microtubule inhibitor, approved for the treatment of pretreated MBC. This multicentric study (sponsored by GIOGer, Italian Group for Geriatric Oncology) was designed to assess the efficacy and tolerability of eribulin, according to parameters usually used in geriatric oncology. Subjects, Materials, and Methods An observational study was conducted on 50 consecutive elderly patients with MBC. The primary endpoint was to evaluate the change in items score of comprehensive geriatric assessment (CGA) and health-related quality of life (HRQL). Italian versions of the CGA and HRQL questionnaires were administered at baseline, before the third and fifth cycles, and then every three cycles until treatment discontinuation. Secondary endpoints were efficacy and safety. Results Overall, both EQ-5D scores and EQ-5D-3 L visual analogic scale did not significantly change from baseline; the percentage of subjects without problems doing usual activities tended to decrease during treatment ( p for linear trend .018), and the percentage of patients with minor problems performing usual activities tended to increase ( p for linear trend.012). Among CGA items, Instrumental Activities of Daily Living tended to decrease during treatment and Geriatric Depression Scale tended to increase. After 12 months follow-up, 24 patients (out of 47) showed clinical benefits; median progression-free survival was 4.49 months (2.10–10.33) and median OS was 7.31 months (3.70–14.03). The treatment was associated with mild toxicity. Conclusion Eribulin treatment preserved quality of life and geriatric parameters included in the CGA, except for instrumental functioning and geriatric depression, in elderly patients with MBC. Implications for Practice A collaboration between oncologist and geriatric specialists is essential in the management of patients with metastatic breast cancer, who are frequently elderly or frail. The assessment of geriatric parameters in the decision-making process can contribute to direct toward the most appropriate therapeutic plan and preserve the quality of life of patients. Eribulin does not seem to affect quality of life or worsen the overall geriatric status; therefore, it can be considered a suitable option for elderly patients with metastatic breast cancer.

【 授权许可】

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