J Breast Cancer.  2016 Jun;19(2):214-217. 10.4048/jbc.2016.19.2.214.

Eribulin Mesylate Combined with Local Treatment for Brain Metastasis from Breast Cancer: Two Case Reports

• Byun KD
• Ahn SG
• Baik HJ
• Lee A
• Bae KB
• An MS
• Kim KH
• Shin JH
• Park HK
• Cho H
• Jeong J
• Kim TH

• KMID: 2308975
• DOI: http://doi.org/10.4048/jbc.2016.19.2.214

Abstract

The prognosis associated with brain metastasis arising from breast cancer is very poor. Eribulin is a microtubule dynamic inhibitor synthesized from halichondrin B, a natural marine product. In a phase III study (EMBRACE), eribulin improved overall survival in patients with heavily pretreated metastatic breast cancers. However, these studies included few patients with brain metastases. Metastatic brain tumors (MBT) were detected during first-line palliative chemotherapy in a 43-year-old woman with breast cancer metastasis to the lung and mediastinal nodes; the genetic subtype was luminal B-like human epidermal growth factor receptor 2 (HER2)-negative. Whole brain radiotherapy (WBRT) followed by eribulin treatment continuously decreased the size, and induced regression, of the MBT with systemic disease stability for 12 months. Another 48-year-old woman with metastatic breast cancer (HER2+ subtype) presented with MBT. Following surgical resection of the tumor, eribulin with concurrent WBRT showed regression of the MBT without systemic progression for 18 months.

Keyword

Brain; Breast neoplasms; Eribulin; Neoplasm metastasis

MeSH Terms

Adult
Brain Neoplasms
Brain*
Breast Neoplasms*
Breast*
Drug Therapy
Female
Humans
Lung
Mesylates*
Microtubules
Middle Aged
Neoplasm Metastasis*
Phenobarbital
Prognosis
Radiotherapy
Receptor, Epidermal Growth Factor
Mesylates
Phenobarbital
Receptor, Epidermal Growth Factor

Figure

• 

  Figure 1 Magnetic resonance imaging in case 1. (A) A heterogeneous enhancing brain parenchymal mass with hemorrhagic component (2.7×2.1 cm) and a rim enhancing cystic mass (1.5×1.2 cm) were identified on right frontoparietal region of the cerebrum in June 2013. (B) Response of metastatic brain tumors to gamma knife stereotactic radiation therapy in October 2013. The metastatic lesion had decreased in size from 2.7 to 2.5 cm. A cystic lesion in anterior portion showed no gross interval change (1.5×1.2 cm)

• 

  Figure 2 Magnetic resonance imaging after whole brain radiotherapy followed by eribulin in case 1. (A) The posterior heterogeneous enhancing lesion and anterior oval shaped cystic lesion had continuously decreased respectively (2.5 to 1.7 cm and 1.5 to 0.8 cm) in January 2014. (B) The heterogeneous enhancing lesion and oval shaped cystic mass had regressed respectively (1.7 to 1.2 cm and 0.8 to 0.6 cm) in July 2014.

• 

  Figure 3 Magnetic resonance imaging after surgery followed by eribulin with concurrent whole brain radiotherapy in case 2. (A) A 2.5 cm metastatic lesion with edema was identified on her left frontal-parietal lobe in July 2014. (B) No tumor recurrence showed in her brain after treatment in November 2015.

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