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Combination Treatment of Vinorelbine With Oral Cyclophosphamide or Capecitabine or Both Might Overcome Cross-resistance Against Eribulin in Advanced Breast Cancer

      Okines et al.
      • Okines AFC
      • Irfan T
      • Mohammed K
      • et al.
      Vinorelbine after prior treatment with eribulin for advanced breast cancer: a single-centre experience suggesting cross-resistance.
      investigated to determine the efficacy of vinorelbine prescribed to patients after prior eribulin in advanced breast cancer (ABC) in this retrospective study. All patients who received vinorelbine after prior eribulin 2011 to 2015 and a parallel cohort of consecutive patients who received vinorelbine without prior eribulin for previously treated ABC between 2005 and 2011 were analyzed. They reported that vinorelbine was of limited benefit after prior eribulin in our study, suggesting cross-resistance. Even without prior eribulin, only 15% of patients experienced clinical benefit from vinorelbine monotherapy. The authors did not mention about possible better way of using vinorelbin after prior eribulin. Metronomic combination chemotherapy is a treatment option for ABC patients who require prolonged disease control without cumulative toxicity. Recent study
      • Montagna E
      • Pagan E
      • Cancello G
      • et al.
      The prolonged clinical benefit with metronomic chemotherapy (VEX regimen) in metastatic breast cancer patients.
      analyzed combination of vinorelbine 30 or 40 mg orally 3 times a week, cyclophosphamide 50 mg daily and capecitabine 500 mg 3 times a day (VEX regimen). The objective response rate was 49%.The progression-free survival at 3 years was 25.4% and at 4 years was 18.5%. Therefore, use of vinorelbine with oral cyclopospamide or capecitabine or both might overcome cross-resistance against eribulin. This issue warrants further investigation.
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      References

        • Okines AFC
        • Irfan T
        • Mohammed K
        • et al.
        Vinorelbine after prior treatment with eribulin for advanced breast cancer: a single-centre experience suggesting cross-resistance.
        Clin Breast Cancer. 2022; (S1526-8209(22)00113-6)
        • Montagna E
        • Pagan E
        • Cancello G
        • et al.
        The prolonged clinical benefit with metronomic chemotherapy (VEX regimen) in metastatic breast cancer patients.
        Anticancer Drugs. 2022; 33: e628-e634