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. 2020 Oct;3(5):e1258.
doi: 10.1002/cnr2.1258. Epub 2020 Jun 17.

Effect of renal function on neutrophil decreases following eribulin administration

Norifumi Suzuki  1 , Hiroyuki Tanaka  2 , Hirotoshi Murakami  3 , Nobumoto Tomioka  4 , Kenichi Watanabe  4 , Masayuki Endo  2 , Masato Takahashi  4
Affiliations

Effect of renal function on neutrophil decreases following eribulin administration

Norifumi Suzuki et al. Cancer Rep (Hoboken). 2020 Oct.

Abstract

Background: Eribulin therapy has recently attracted attention from various viewpoints, including quality of life, and is considered a standard therapy for inoperable or recurrent breast cancer. Although a reduction in renal function reportedly decreases total eribulin clearance, its association with dose-limiting toxicity and the reduction of neutrophils remain unclear.

Aim: This study was aimed at analyzing the association between decreased renal function prior to eribulin administration and the occurrence of neutrophil reduction and time to treatment failure in patients with breast cancer.

Methods and results: We retrospectively assessed patients with breast cancer, who underwent eribulin therapy between July 2011 and March 2018. Multivariate analysis revealed creatinine clearance <70 mL/min and serum albumin levels <3.9 mg/dL as predictive factors for neutrophil reduction. Even on increasing the relative dose intensity by these factors, no difference in time to treatment failure was observed, suggesting that treatment efficacy is potentially unaffected.

Conclusions: For continuous eribulin therapy, eribulin may need to be administered to individual patients in accordance with renal function and albumin levels before treatment initiation.

Keywords: breast cancer; eribulin; renal function; serum albumin levels; time to treatment failure.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Incidence of neutropenia in accordance with renal function. Black, Ccr ≥80 mL/min; Gray, 51 ≤ Ccr ≤79 mL/min; White, 30 ≤ Ccr ≤50 mL/min. Ccr: creatinine clearance
FIGURE 2
FIGURE 2
Risk factors for neutropenia and ROC curves. Cut‐off values for Ccr (the area under the ROC curve: 0.646, 95% CI: 0.530‐0.762) and serum ALB levels (the area under the ROC curve: 0.652, 95% CI: 0.530‐0.774) determined via multivariate analysis were used as reference values from an ROC curve. Ccr, creatinine clearance; ALB, serum albumin levels; ROC, receiver operating characteristic
FIGURE 3
FIGURE 3
Kaplan–Meier Curves for time to treatment failure according to creatinine clearance and serum albumin levels. A, There was no difference in TTF among the three groups (HR: 1.216, 95% CI: 0.678‐2.181, P = 0.512). B, There was no difference in TTF between pairs of groups (HR: 1.204, 95% CI: 0.781‐1.857, P = 0.400). Ccr, creatinine clearance; ALB, serum albumin levels; TTF, time to treatment failure
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