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Research Article
Yuichiro Kikawa
Kansai Medical University Hirakata Hospital: Kansai Ika Daigaku Fuzoku Hirakata Byoin
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3852-5991
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose
To investigate the survival impact of eribulin use in first-line and second-line chemotherapy for patients with endocrine-resistant advanced or metastatic breast cancer (AMBC) in the real-world clinical setting.
Methods
This multi-institutional prospective cohort study enrolled patients with triple-negative AMBC or estrogen receptor (ER)-positive AMBC refractory to at least one previous endocrine therapy selected at the physician’s discretion. The overall survival from the start of first-line (OS1) and second-line chemotherapy (OS2) were assessed. Adjusted hazard ratio (HR) between eribulin and the other regimens (oral 5-fluorouracil [5-FU] and anthracycline/taxane) was calculated using a stratified proportional hazards model that included prespecified prognostic factors.
Results
Of the 201 patients enrolled, 180 were included in the final analysis. Baseline patient characteristics were quite diverse among regimens. The median OS1 was 2.25, 3.49, and 2.62 years for eribulin (n=46), oral 5-FU (n=57), and anthracycline/taxane (n=71), and the median OS2 was 1.75, 2.33, and 1.69 years for eribulin (n=70), oral 5-FU (n=26), and anthracycline/taxane (n=44), respectively. First-line eribulin had a worse adjusted HR for OS than the other regimens in the ER-negative cohort; second-line oral 5-FU had a better adjusted HR for OS than eribulin in the ER-positive cohort. There was no significant difference between regimens in the other subgroups.
Conclusions
Eribulin and anthracycline/taxane resulted in similar point estimates for OS, while oral 5-FU led to relatively longer survival. Adjusted HRs differed based on treatment line and ER status. However, caution should be exercised when interpreting the results due to the heterogamies in patient background.
Trial registration number and date of registration
Clinical Trials.gov (NCT 02551263), July 22, 2015.
Keywords
Breast cancer, Metastasis, Eribulin, Chemotherapy sequence
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
- SupplementaryFigS1.pdf
Reasons for the choice of eribulin before the administration of anthracyclines or taxanes.
- SupplementaryFigS2.pdf
Kaplan–Meier estimates for overall survival from the initiation of first-line chemotherapy among the three most frequently used first- to second-line chemotherapy sequences.
- SupplementaryTableS1.doc
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Yuichiro Kikawa
Kansai Medical University Hirakata Hospital: Kansai Ika Daigaku Fuzoku Hirakata Byoin
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3852-5991
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 14 Apr, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose
To investigate the survival impact of eribulin use in first-line and second-line chemotherapy for patients with endocrine-resistant advanced or metastatic breast cancer (AMBC) in the real-world clinical setting.
Methods
This multi-institutional prospective cohort study enrolled patients with triple-negative AMBC or estrogen receptor (ER)-positive AMBC refractory to at least one previous endocrine therapy selected at the physician’s discretion. The overall survival from the start of first-line (OS1) and second-line chemotherapy (OS2) were assessed. Adjusted hazard ratio (HR) between eribulin and the other regimens (oral 5-fluorouracil [5-FU] and anthracycline/taxane) was calculated using a stratified proportional hazards model that included prespecified prognostic factors.
Results
Of the 201 patients enrolled, 180 were included in the final analysis. Baseline patient characteristics were quite diverse among regimens. The median OS1 was 2.25, 3.49, and 2.62 years for eribulin (n=46), oral 5-FU (n=57), and anthracycline/taxane (n=71), and the median OS2 was 1.75, 2.33, and 1.69 years for eribulin (n=70), oral 5-FU (n=26), and anthracycline/taxane (n=44), respectively. First-line eribulin had a worse adjusted HR for OS than the other regimens in the ER-negative cohort; second-line oral 5-FU had a better adjusted HR for OS than eribulin in the ER-positive cohort. There was no significant difference between regimens in the other subgroups.
Conclusions
Eribulin and anthracycline/taxane resulted in similar point estimates for OS, while oral 5-FU led to relatively longer survival. Adjusted HRs differed based on treatment line and ER status. However, caution should be exercised when interpreting the results due to the heterogamies in patient background.
Trial registration number and date of registration
Clinical Trials.gov (NCT 02551263), July 22, 2015.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
- SupplementaryFigS1.pdf
Reasons for the choice of eribulin before the administration of anthracyclines or taxanes.
- SupplementaryFigS2.pdf
Kaplan–Meier estimates for overall survival from the initiation of first-line chemotherapy among the three most frequently used first- to second-line chemotherapy sequences.
- SupplementaryTableS1.doc
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