Eribulin Does Not Prolong Overall Survival in Non-small Cell Lung Cancer

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While eribulin is not superior in prolonging OS compared with the established second- and third-line therapies, it may have a role as a third-line agent.
While eribulin is not superior in prolonging OS compared with the established second- and third-line therapies, it may have a role as a third-line agent.

Eribulin does not prolong overall survival (OS) compared with treatment of physician's choice (TPC) among patients with non–small cell lung cancer (NSCLC), according to a study published in the Annals of Oncology.1

Previously conducted studies show conflicting data regarding the survival benefit of eribulin in various cancers, including NSCLC. These data show that eribulin may have clinical application in a second- or third-line setting.

For this phase 3 study (ClinicalTrials.gov Identifier: NCT01454934), researchers assigned 540 patients who failed at least 2 previous therapies 1:1 to receive intravenous eribulin 1.4 mg/m2 or TPC. TPC included 4 agents typically reserved for second- or third- line therapies.

The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS) and objective response rate (ORR). Patients received a survival follow-up every 12 weeks.

Eribulin and TPC had an identical median OS of 9.5 months (hazard ratio [HR], 1.16; 95% CI, 0.95-1.41; P = .13). PFS for eribulin was 3.0 months vs 2.8 months for TPC (HR, 1.09; 95% CI, 0.90-1.32; P = 0.39).

The ORRs for eribulin and TPC were 12% and 15%, respectively.

The most frequently observed adverse effects (AE) were all-grade neutropenia, which was reported in 57% of eribulin patients and 49% of TPC patients, and all-grade peripheral neuropathy, which was reported 16% of eribulin patients and 9% of TPC patients.

Rates of other AEs were similar and manageable in both treatment arms.

RELATED: Overcoming Resistance to ALK Inhibition in Lung Cancer

The authors concluded that while eribulin is not superior in prolonging OS compared with the established second- and third-line therapies, it may have a role as a third-line agent. 

Reference

  1. Katakami N, Felip E, Spigel DR, et al. A randomized, open-label, multicenter, phase 3 study to compare the efficacy and safety of eribulin to treatment of physician's choice in patients with advanced non-small cell lung cancer. Ann Oncol. 2017 Jul 19. doi: 10.1093/annonc/mdx284 [Epub ahead of print]

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