Multicenter phase 3 noninferiority trial of eribulin versus taxane added to first-line trastuzumab-pertuzumab for HER2-positive advanced breast cancer

Trastuzumab-pertuzumab (HP) plus taxane-based chemotherapy is a current standard first-line therapy for locallay advanced or metastatic HER2 breast cancer (HER2+ aBC). Taxane-induced toxicities necessitate development of less toxic but at least equally effective alternatives. The multicenter noninferiority phase 3 EMERALD study compared eribulin versus taxane (docetaxel or paclitaxel) added to first-line HP for HER2+ aBC. The median progression-free survival was 14.0 months in the eribulin group versus 12.9 months in the taxane group, which confirmed the noninferiority of the study regimen. The median overall survival was not reached in the eribulin group and was 65.3 months in the taxane group. Median time to quality of life deterioration was numerically longer with eribulin than with taxane. The authors conclude that HP plus eribulin is an option for first-line treatment of HER+ aBC.