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Clinical evidence for the role of eribulin mesylate in the treatment of breast cancer

Carole Gourmelon, Jean Sebastien Frenel,Mario Campone

The development of drugs improving overall survival (OS) in late-stage metastatic breast cancer (MBC) remains a challenge. Eribulin mesylate, a new chemotherapy agent, has shown significant results in this setting. This agent is a synthetic analog of a macrolide isolated from a marine sponge. It inhibits microtubule polymerization, inducing mitotic arrest and apoptosis, and aggregates soluble tubulin in a nonproductive form. In Phase II studies, this drug gave a partial response and stable disease. The EMBRACE study showed that eribulin mesylate improved OS in heavily pretreated (particularly with anthracycline and taxane) MBC with good tolerance. Currently, eribulin mesylate is the first major single-agent that has improved OS in heavily pretreated MBC. These results suggest that this drug could become a new standard in the treatment of advanced breast cancer and should be developed in earlier stages.