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. Because breast cancer in this setting is not curable, treatment goals include improving/maintaining quality of life, reducing tumor-related symptoms, and prolonging survival. We report on a 42-year-old Hispanic woman with invasive ductal carcinoma (T4 N1 M1), positive for estrogen and progesterone receptors and negative for HER2. She had been heavily pretreated with radiation (to bone metastases), hormonal therapy, and multiple systemic therapies—including a nanoparticle albumin-bound paclitaxel/bevacizumab/gemcitabine combination and pegylated liposomal doxorubicin. Because of toxicity or disease progression, none of these treatments was used for more than 4 months. After receiving eribulin (in a clinical trial), the patient remained in stable disease for 21 months and generally tolerated eribulin well. (Thrombocytopenia with resulting gastrointestinal bleeding occurred but was resolved with a dose reduction.) The case is discussed in the context of current treatment goals and modalities in the setting of late-line metastatic breast cancer. Treatment options include newer chemotherapeutic agents such as eribulin, a recently approved non-taxane microtubule dynamics inhibitor whose mechanism of action differs from that of other tubulin-targeting agents.