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Eribulin is a chemotherapy drug that was approved by the FDA as a third-line agent in metastatic breast cancer, specifically in patients whose disease progressed after receiving an anthracycline and a taxane. Joanne Blum, MD, PhD, comments that eribulin is well tolerated. Common adverse reactions associated with eribulin include cytopenia, alopecia, and neuropathy. Eribulin is also active in triple-negative breast cancer, and future trials investigating the efficacy of eribulin in combination with other agents, such as capecitabine, are ongoing. Based on her experience with capecitabine and paclitaxel in combination, Blum believes that eribulin and capecitabine, which do not have competing side effects, may make an effective combination in that setting.
Adam Brufsky, MD, elaborates on the management of relapse in triple-negative disease, noting that the timing and pattern of recurrence are important considerations. Brufsky notes the majority of triple-negative breast cancer patients relapse in the visceral organs, such as in the lung or liver. In these cases, cytotoxic chemotherapy is the standard of care. If an individual relapses at least 12 to 15 months after adjuvant therapy, Brufsky prefers to retreat them with a taxane-based therapy first followed by gemcitabine. However, if a patient relapsed within 12 months, Brufsky begins eribulin, noting success in early relapse populations as well as in individuals who used eribulin as second-line therapy.