Eribulin for the treatment of metastatic breast cancer: an update on its safety and efficacy.
Eribulin for the treatment of metastatic breast cancer: an update on its safety and efficacy.
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DOI：
10.2147/ijwh.s74462
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Morris PG
中科院分区：
文献类型：
--
作者：
Doherty MK;Morris PG
乳腺癌仍然是全球癌症相关死亡的主要原因。转移性乳腺癌的治疗方法近年来有所发展;然而，化疗仍然是大多数患者的核心组成部分。蒽环类和紫杉烷类药物已被广泛研究并形成标准治疗。甲磺酸艾日布林是一种基于天然化合物的新型合成微管导向化疗药物。通过I期研究，发现艾日布林是可耐受的，并且在转移性乳腺癌患者中观察到活性。转移性乳腺癌的II期研究进一步证明了其疗效，与其他研究的化疗药物相比，其反应和生存率更高。III期EMBRACE研究显示，与接受医生选择对照的患者相比，接受艾日布林治疗的患者的生存率上级。这导致它在许多国家被批准用于这种环境。其毒性特征已得到充分证实，大部分可管理，最常见的报告毒性为脱发、疲劳、中性粒细胞减少和周围神经病变。第二项报告的III期研究比较了艾日布林与卡培他滨，但未能显示出预治疗患者的生存率改善。本文综述了艾日布林的临床药理学和作用机制，并总结了艾日布林在转移性乳腺癌中的主要临床前和临床研究结果。
Breast cancer remains a leading cause of cancer-related death internationally. Treatment approaches for metastatic breast cancer have evolved in recent years; however chemotherapy remains a core component for the majority of patients. Agents such as anthracyclines and taxanes have been extensively studied and form standard treatment. Eribulin mesylate is a novel synthetic microtubule-directed chemotherapy, based on a naturally-occurring compound. Through phase I studies, eribulin was found to be tolerable and activity was seen in patients with metastatic breast cancer. Phase II studies in metastatic breast cancer further demonstrated its efficacy, with responses and survival which compare favorably with other studied chemotherapy agents. The phase III EMBRACE study showed superior survival for patients treated with eribulin compared with those who received a physician’s choice control. This led to its approval for use in many countries in this setting. Its toxicity profile is well established and manageable for the most part, with the commonest reported toxicities being alopecia, fatigue, neutropenia and peripheral neuropathy. A second reported phase III study comparing eribulin to capecitabine failed to show an improvement in survival in pretreated patients. This article reviews the clinical pharmacology and mechanism of action of eribulin, and summarizes the results of the major preclinical and clinical studies of eribulin in metastatic breast cancer.