ASCO 2024: Taxane-Free First-Line Regimen for Advanced HER2-Positive Breast Cancer

By: Julia Cipriano, MS
Posted: Friday, June 7, 2024

The results of the Japanese multicenter phase III JBCRG-M06/EMERALD trial, which were presented during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 1007), revealed first-line eribulin mesylate is not inferior to a taxane when administered with dual HER2 blockade in patients with locally advanced or metastatic HER2-positive breast cancer. According to Toshinari Yamashita, MD, PhD, of Kanagawa Cancer Center, Japan, and colleagues, this taxane-free regimen represents a less toxic but equally effective alternative.

“Trastuzumab plus pertuzumab and a taxane is a current standard first-line therapy for recurrent or metastatic [disease],” the investigators commented. “However, taxane-induced toxicities reduce patient quality of life.”

Between August 2017 and June 2021, a total of 446 patients (median age, 56 years) were randomly assigned in a 1:1 ratio to receive trastuzumab plus pertuzumab and either eribulin mesylate or a taxane (docetaxel or paclitaxel). De novo stage IV disease, estrogen receptor–positive disease, and visceral metastasis were documented in 55.4%, 54.7%, and 63.9% of the population, respectively. A total of 44.6% of patients underwent radical surgery, and 30.9% of patients received a taxane in the perioperative setting. The baseline characteristics were reported to be well balanced between the groups.

The median duration of progression-free survival was extended with dual HER2 blockade plus eribulin mesylate vs a taxane (14.0 vs 12.9 months; hazard ratio = 0.96), establishing noninferiority of the former regimen. The median durations of overall survival were not reached and 65.3 months, respectively. As for toxicity, adverse drug reactions of grade 3 or higher, including febrile neutropenia (4.9% vs 8.7%), edema (8.5% vs 42.2%), and diarrhea (36.6% vs 54.1%), were reported less frequently with eribulin mesylate than with a taxane.  

Disclosure: For full disclosures of the study authors, visit coi.asco.org.

2024 ASCO Annual Meeting

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