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

Silvana Leo, Ermenegildo Arnoldi, Lazzaro Repetto, Zaira Coccorullo, Saverio Cinieri, Mina Fedele, Marina Cazzaniga, Vito Lorusso, Agnese Latorre, Giovanna Campanella, Mariangela Ciccarese, Caterina Accettura, Salvatore Pisconti, Antonio Rinaldi, Cosimo Brunetti, Mimma Raffaele, Luigi Coltelli, Salvatore Spazzapan, Lucia Fratino, Luciana Petrucelli & 1 others Laura Biganzoli

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalOncologist
DOIs
Publication statusAccepted/In press - Jan 1 2018

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eribulin
Geriatrics
Observational Studies
Geriatric Assessment
Breast Neoplasms
Drug Therapy
Quality of Life
Therapeutics
Depression
Frail Elderly
Activities of Daily Living
Microtubules

Keywords

  • Comprehensive geriatric assessment
  • Elderly
  • Eribulin mesylate
  • Health-related quality of life
  • Metastatic breast cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

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. / Leo, Silvana; Arnoldi, Ermenegildo; Repetto, Lazzaro; Coccorullo, Zaira; Cinieri, Saverio; Fedele, Mina; Cazzaniga, Marina; Lorusso, Vito; Latorre, Agnese; Campanella, Giovanna; Ciccarese, Mariangela; Accettura, Caterina; Pisconti, Salvatore; Rinaldi, Antonio; Brunetti, Cosimo; Raffaele, Mimma; Coltelli, Luigi; Spazzapan, Salvatore; Fratino, Lucia; Petrucelli, Luciana; Biganzoli, Laura.

In: Oncologist, 01.01.2018.

Research output: Contribution to journalArticle

Leo, Silvana ; Arnoldi, Ermenegildo ; Repetto, Lazzaro ; Coccorullo, Zaira ; Cinieri, Saverio ; Fedele, Mina ; Cazzaniga, Marina ; Lorusso, Vito ; Latorre, Agnese ; Campanella, Giovanna ; Ciccarese, Mariangela ; Accettura, Caterina ; Pisconti, Salvatore ; Rinaldi, Antonio ; Brunetti, Cosimo ; Raffaele, Mimma ; Coltelli, Luigi ; Spazzapan, Salvatore ; Fratino, Lucia ; Petrucelli, Luciana ; Biganzoli, Laura. / 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. In: Oncologist. 2018.
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abstract = "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{\^a}€“10.33) and median OS was 7.31 months (3.70{\^a}€“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.",
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T1 - Eribulin Mesylate as Third or Subsequent Line Chemotherapy for Elderly Patients with Locally Recurrent or Metastatic Breast Cancer

T2 - A Multicentric Observational Study of GIOGer (Italian Group of Geriatric Oncology)-ERIBE

AU - Leo, Silvana

AU - Arnoldi, Ermenegildo

AU - Repetto, Lazzaro

AU - Coccorullo, Zaira

AU - Cinieri, Saverio

AU - Fedele, Mina

AU - Cazzaniga, Marina

AU - Lorusso, Vito

AU - Latorre, Agnese

AU - Campanella, Giovanna

AU - Ciccarese, Mariangela

AU - Accettura, Caterina

AU - Pisconti, Salvatore

AU - Rinaldi, Antonio

AU - Brunetti, Cosimo

AU - Raffaele, Mimma

AU - Coltelli, Luigi

AU - Spazzapan, Salvatore

AU - Fratino, Lucia

AU - Petrucelli, Luciana

AU - Biganzoli, Laura

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Comprehensive geriatric assessment

KW - Elderly

KW - Eribulin mesylate

KW - Health-related quality of life

KW - Metastatic breast cancer

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