scholarly journals Combination Chemotherapy of Mitomycin C and Methotrexate Was Effective on Metastatic Breast Cancer Resistant to Eribulin, Vinorelbine, and Bevacizumab after Anthracycline, Taxane, and Capecitabine

2016 ◽  
Vol 9 (2) ◽  
pp. 422-426 ◽  
Author(s):  
Masahiko Tanabe
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Mitomycin C ◽  
Combination Chemotherapy ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Sequential Treatment ◽  
New Drugs ◽  
Epidermal Growth ◽  
Hormonal Therapies

Complete cure of metastatic breast cancer (MBC) is still considered difficult even after the development of new drugs. While new drugs have been continuously developed, conventional drugs such as mitomycin C (MMC) and methotrexate (MTX) have become less used. Combination chemotherapy with MMC and MTX (MMC/MTX) was reported to be effective for 9.7–19.4% of 31 patients with human epidermal growth factor receptor type 2 (HER2)-negative MBC who were aggressively treated with anthracycline, taxane, capecitabine, and vinorelbine. However, its efficacy, when it is used after newly developed drugs such as eribulin and bevacizumab, is yet to be evaluated. We here introduce one case in which MMC/MTX was effective for MBC that was resistant to chemotherapy with eribulin, vinorelbine, and bevacizumab with paclitaxel after sequential treatment with anthracycline, taxane, capecitabine, and several hormonal therapies. Lung metastasis was newly observed after sequential treatment of MBC for 6 years. Although the disease was resistant to chemotherapy of eribulin, vinorelbine, and bevacizumab with paclitaxel, it responded well to the treatment of MMC/MTX, which continued for 7 months. This case suggests that MMC/MTX could be an effective treatment for MBC patients when the disease progressively develops even after aggressive treatment with multiple regimens.

scholarly journals PALOMA-3: Phase III Trial of Fulvestrant With or Without Palbociclib in Premenopausal and Postmenopausal Women With Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Metastatic Breast Cancer That Progressed on Prior Endocrine Therapy—Safety and Efficacy in Asian Patients

2017 ◽  
Vol 3 (4) ◽  
pp. 289-303 ◽  
Author(s):  
Hiroji Iwata ◽  
Seock-Ah Im ◽  
Norikazu Masuda ◽  
Young-Hyuck Im ◽  
Kenichi Inoue ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Endocrine Therapy ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Asian Patients ◽  
Hormone Receptor Positive ◽  
Patient Reported ◽  
Epidermal Growth

Purpose To assess efficacy and safety of palbociclib plus fulvestrant in Asians with endocrine therapy–resistant metastatic breast cancer. Patients and Methods The Palbociclib Ongoing Trials in the Management of Breast Cancer 3 (PALOMA-3) trial, a double-blind phase III study, included 521 patients with hormone receptor–positive/human epidermal growth factor receptor 2–negative metastatic breast cancer with disease progression on endocrine therapy. Patient-reported outcomes (PROs) were assessed on study treatment and at the end of treatment. Results This preplanned subgroup analysis of the PALOMA-3 study included premenopausal and postmenopausal Asians taking palbociclib plus fulvestrant (n = 71) or placebo plus fulvestrant (n = 31). Palbociclib plus fulvestrant improved progression-free survival (PFS) compared with fulvestrant alone. Median PFS was not reached with palbociclib plus fulvestrant (95% CI, 9.2 months to not reached) but was 5.8 months with placebo plus fulvestrant (95% CI, 3.5 to 9.2 months; hazard ratio, 0.485; 95% CI, 0.270 to 0.869; P = .0065). The most common all-cause grade 3 or 4 adverse events in the palbociclib arm were neutropenia (92%) and leukopenia (29%); febrile neutropenia occurred in 4.1% of patients. Within-patient mean trough concentration comparisons across subgroups indicated similar palbociclib exposure between Asians and non-Asians. Global quality of life was maintained; no statistically significant changes from baseline were observed for patient-reported outcome scores with palbociclib plus fulvestrant. Conclusion This is the first report, to our knowledge, showing that palbociclib plus fulvestrant improves PFS in asian patients. Palbociclib plus fulvestrant was well tolerated in this study.

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