PracticeUpdate: Haematology & Oncology

ECCO2017 17

Eribulinmesilate is shown to suppress epithelial–mesenchymal transition in tumours of patients withmetastatic breast cancer E ribulin mesilate has been shown to suppress epithelial–mesenchymal transition in tumours of patients with

(9.1%), and decreased in eight (72.7%). N-cadherin protein levels were increased in one tumour (9.1%), unchanged in four tumours (36.4%), and decreased in six tumours (54.5%). Dr Utsumi concluded that the study demon- strated that eribulin treatment suppressed the epithelial–mesenchymal transition in tumours from patients with metastatic breast cancer. The results suggested that eribulin showed antitumour activity by improving the tumour microenvironment. The finding may provide a scientific basis of underlying mechanisms for improvement of overall survival of patients with metastatic breast cancer treated with eribulin. Dr Utsumi added, “We cannot completely confirm that eribulin suppress the epithelial– mesenchymal transition in tumours, because the study was small and is still ongoing. But, I think our preliminary results have shown that eribulin can potentially suppress the epithelial–mesenchymal transition. I base this conclusion on the observation that after eribulin treatment, epithelial makers were increased and mesenchymal markers decreased in two thirds of tumours.” “We hope to further study eribulin in an effort to understand its mechanism of anticancer effect.”

Patients with recurrent or metastatic breast cancer were treated with eribulin 1.4 mg/m 2 intravenously on days 1 and 8 of a 21-day cycle. Treatment continued until disease progression, unacceptable toxic effects, or discontinuation request from patients or physicians. Breast cancer tissue samples were obtained from patients before and on day 15 of the first cycle of eribulin treatment. Epithelial– mesenchymal markers (E-cadherin, claudin, N-cadherin, vimentin) were analysed by western blot. Change in protein expression from baseline to day 15 ± 4 in epithelia–mesenchymal transition-related markers in tumour tissue was assessed. Eleven patients were enrolled. Median patient age was 63 (44–72) years. Of the 11 tumours, six were luminal B and five tri- ple-negative. Zero (0–3) prior chemotherapy regimens had been administered for recurrent or metastatic disease. After treatment, E-cadherin protein levels were increased in seven tumours (63.6%), unchanged in one tumour (9.1%), and decreased in three (27.3%). Claudin protein levels were increased in eight tumours (72.7%) and decreased in three tumours (27.3%). Vimentin protein levels were increased in two tumours (18.2%), unchanged in one tumour

metastatic breast cancer. This was the finding of the first prospec- tive investigation of the effect of eribulin on expression of epithelial–mesenchymal transi- tion markers in tumours from patients with metastatic breast cancer. Toshiaki Utsumi, MD, of Fujita Health University, Toyoake, Japan, explained that recent evidence suggests that epithelial–mesenchymal transition contributes to metastasis in patients with breast cancer and leads to poor prognosis. Pivotal phase III tri- als have shown that eribulin improved overall survival in patients with triple-negative met- astatic breast cancer. “Preclinical studies have demonstrated that eribulin suppressed epithelial–mesenchymal transition,” Dr Utsumi said. “This phenome- non could be one of the underlying reasons for the improved prognosis of patients with metastatic breast cancer treated with eribu- lin. No direct clinical data, however, exists on the effect of eribulin treatment on epithelial– mesenchymal transition in tumours of patients with metastatic breast cancer.” He added, “So we designed a prospective study to clarify whether eribulin suppresses epithelial–mesenchymal transition in tumours of patients with metastatic breast cancer.” laboratory tests and ultrasonography, con- trast-enhanced CT scanning, and MRI scanning was 42 months (3.5 years). No deterioration in renal function was observed postoperatively. Dr Cuni concluded that appropriate patient selection criteria and surgical techniques are important for satisfactory functional long- term outcome of nephron-sparing surgery. Open nephron-sparing surgery and laparo- scopic radical nephrectomy are relatively recent, significant developments for treat- ing renal tumours and represent acceptable standards of care in cases of small renal mass and normal contralateral kidney. Nephron-sparing surgery has become a modality of choice in Dr Cuni’s centre for patients with renal tumour size <4 cm. The present data suggest that nephron-sparing surgery can be performed safely and with maximum preservation of renal function.

PracticeUpdate Editorial Team

PracticeUpdate Editorial Team

© ECCO2017 European Cancer Congress

VOL. 2 • NO. 2 • 2017