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The purpose of this study is to assess the feasibility of dose-dense doxorubicin and cyclophosphamide followed by eribulin mesylate for adjuvant treatment of early stage breast cancer.
This is a multicenter, single-arm Phase II trial to assess the feasibility of dose-dense adjuvant chemotherapy in subjects with early stage (I-III), HER-2 normal breast cancer. A total of 80 adult subjects will be enrolled in order to have 73 subjects who start the eribulin portion of the adjuvant study regimen. After completion of 4 cycles of AC, each subject will begin 4 cycles of eribulin mesylate 1.4 mg/m2 intravenously over 2 to 5 minutes on Days 1 and 8 of every 21 day cycle.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Doxorubicin and cyclophosphamide followed by eribulin mesylate | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| eribulin mesylate | Drug | Dose dense doxorubicin and cyclophosphamide for 4 cycles during the first 8 weeks followed by eribulin mesylate 1.4mg/m2 for 4 cycles during the next 12 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With Feasibility | The regimen was considered feasible if the participant was able to complete the eribulin portion without dose delay or reduction. Dose delay was defined as a delay due to eribulin-related adverse event (AE) for more than 2 days for subsequent doses (cycles after the initiation of full dose of eribulin, except holidays, scheduling difficulties and nonclinical logistical issues). If a participant had more than 1 dose omission, delay or reduction due to eribulin-related AE, these events were collectively counted as one entity in the same participant. Participants were followed for approximately 3 years after the last dose of the study treatment. Feasibility rates were calculated with or without growth factor support. In both cohorts, the percentage of participants who completed the eribulin portion of the regimen without a dose omission, delay or reduction due to eribulin-related AE was estimated via the observed completion rate and an exact 90% confidence interval (CI) was constructed. | From date of first dose, up to 3 years after the last dose of study treatment, or up to approximately 4 years 2 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Non-serious Adverse Events and Serious Adverse Events (SAEs) | Safety assessments consisted of monitoring and recording all AEs and SAEs, clinical laboratory results, vital signs, physical examinations, Eastern Cooperative Oncology Group (ECOG) performance status, electrocardiograms (ECGs), and left-ventricular ejection fracture (LVEF) by multigated acquisition scan (MUGA) or echocardiogram. An AE was considered a treatment emergent adverse event (TEAE) if the AE onset date was on or after the first dose of study drug and up to 30 days after receiving the last dose of study drug. Treatment-related TEAEs included TEAEs that were considered by the Investigator to be possibly or probably related to eribulin mesylate and/or doxorubicin/cyclophosphamide, or missing causality. Standardized Medical Dictionary for Regulatory Activities Queries (SMQ). |
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Inclusion Criteria
Exclusion Criteria
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dartmouth-Hitchcock Medical Center ,Norris Cotton Cancer Center | Lebanon | New Hampshire | 03756 | United States | ||
A total of 81 participants were enrolled out of which 2 participants did not receive eribulin mesylate and were excluded from the eribulin-treated analysis sets (79 participants made up the Eribulin-treated Analysis Set and Eribulin-treated Safety Analysis Set).
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| ID | Title | Description |
|---|---|---|
| FG000 | Cohort 1: Eribulin Mesylate With Filgrastim as Needed | Participants initially received doxorubicin (60 milligram per square meter [mg/m^2]) plus cyclophosphamide (600 mg/m^2) intravenously (IV) on Day 1, of every 14-day cycle for 4 cycles. Eribulin mesylate was administered following the doxorubicin plus cyclophosphamide regimen at a dose of 1.4 mg/m^2 IV over 2 to 5 minutes on Days 1 and 8 of a 21-day cycle for 4 cycles (Cycles 5 to 8). In this Cohort growth factors, subcutaneous pegfilgrastim (6 mg) or filgrastim, could be used with eribulin therapy at the physician's discretion if neutropenia occurred that recovered to Grade ≤2. |
| FG001 | Cohort 2: Eribulin Mesylate With Prophylactic Filgrastim | Participants initially received doxorubicin (60 mg/m^2) plus cyclophosphamide (600 mg/m^2) IV on Day 1, of every 14-day cycle for 4 cycles. Eribulin mesylate was administered following the doxorubicin plus cyclophosphamide regimen at a dose of 1.4 mg/m^2 IV over 2 to 5 minutes on Days 1 and 8 of a 21-day cycle for 4 cycles (Cycles 5 to 8). In this Cohort filgrastim was used with eribulin therapy at a dose of 300 micrograms for participants ≤60 kg or 480 micrograms for participants >60 kg, administered subcutaneously on Days 3 and 4 and Days 10 and 11 of each eribulin cycle. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Cohort 1: Eribulin Mesylate With Filgrastim as Needed | Participants initially received doxorubicin (60 mg/m^2) plus cyclophosphamide (600 mg/m^2) intravenously (IV) on Day 1, of every 14-day cycle for 4 cycles. Eribulin mesylate was administered following the doxorubicin plus cyclophosphamide regimen at a dose of 1.4 mg/m^2 IV over 2 to 5 minutes on Days 1 and 8 of a 21-day cycle for 4 cycles (Cycles 5 to 8). In this Cohort growth factors, subcutaneous pegfilgrastim (6 mg) or filgrastim, could be used with eribulin therapy at the physician's discretion if neutropenia occurred that recovered to Grade ≤2. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percentage of Participants With Feasibility | The regimen was considered feasible if the participant was able to complete the eribulin portion without dose delay or reduction. Dose delay was defined as a delay due to eribulin-related adverse event (AE) for more than 2 days for subsequent doses (cycles after the initiation of full dose of eribulin, except holidays, scheduling difficulties and nonclinical logistical issues). If a participant had more than 1 dose omission, delay or reduction due to eribulin-related AE, these events were collectively counted as one entity in the same participant. Participants were followed for approximately 3 years after the last dose of the study treatment. Feasibility rates were calculated with or without growth factor support. In both cohorts, the percentage of participants who completed the eribulin portion of the regimen without a dose omission, delay or reduction due to eribulin-related AE was estimated via the observed completion rate and an exact 90% confidence interval (CI) was constructed. | The eribulin-treated analysis set included all participants who received at least 1 dose of eribulin mesylate at the starting dose of 1.4 mg/m^2. This was the primary analysis set for the feasibility evaluation. | Posted | Number | 90% Confidence Interval | Percentage of participants | From date of first dose, up to 3 years after the last dose of study treatment, or up to approximately 4 years 2 months |
From date of first dose up to 30 days after the last dose of study treatment, or up to approximately 4 years 2 months
Treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) were reported. AEs were graded on a 5-point scale according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0. All SAEs were reported, no fatal AEs, and all SAEs have CTCAE grade less than (<) 4. The safety analysis set consisted of participants who were enrolled, received at least 1 dose of study treatments, and had at least 1 post-treatment safety assessment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cohort 1: Eribulin Mesylate With Filgrastim as Needed | Participants initially received doxorubicin (60 mg/m^2) plus cyclophosphamide (600 mg/m^2) intravenously (IV) on Day 1, of every 14-day cycle for 4 cycles. Eribulin mesylate was administered following the doxorubicin plus cyclophosphamide regimen at a dose of 1.4 mg/m^2 IV over 2 to 5 minutes on Days 1 and 8 of a 21-day cycle for 4 cycles (Cycles 5 to 8). In this Cohort growth factors, subcutaneous pegfilgrastim (6 mg) or filgrastim, could be used with eribulin therapy at the physician's discretion if neutropenia occurred that recovered to Grade ≤2. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Febrile neutropenia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Eisai Medical Information | Eisai Inc. | 1-888-422-4743 | esi_oncmedinfo@eisai.com |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C490954 | eribulin |
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| From date of first dose up to 30 days after the last dose of study treatment, or up to approximately 4 years 2 months |
| Memorial Sloan-Kettering Cancer Center |
| New York |
| New York |
| 10065 |
| United States |
| Withdrawal by Subject |
|
| Moved before end of treatment visit |
|
| Subject choice |
|
| Protocol Violation |
|
| BG001 | Cohort 2: Eribulin Mesylate With Prophylactic Filgrastim | Participants initially received doxorubicin (60 mg/m^2) plus cyclophosphamide (600 mg/m^2) IV on Day 1, of every 14-day cycle for 4 cycles. Eribulin mesylate was administered following the doxorubicin plus cyclophosphamide regimen at a dose of 1.4 mg/m^2 IV over 2 to 5 minutes on Days 1 and 8 of a 21-day cycle for 4 cycles (Cycles 5 to 8). In this Cohort filgrastim was used with eribulin therapy at a dose of 300 micrograms for participants ≤60 kg or 480 micrograms for participants >60 kg, administered subcutaneously on Days 3 and 4 and Days 10 and 11 of each eribulin cycle. |
| BG002 | Total | Total of all reporting groups |
| Years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
|
|
|
|
| Secondary | Number of Participants With Non-serious Adverse Events and Serious Adverse Events (SAEs) | Safety assessments consisted of monitoring and recording all AEs and SAEs, clinical laboratory results, vital signs, physical examinations, Eastern Cooperative Oncology Group (ECOG) performance status, electrocardiograms (ECGs), and left-ventricular ejection fracture (LVEF) by multigated acquisition scan (MUGA) or echocardiogram. An AE was considered a treatment emergent adverse event (TEAE) if the AE onset date was on or after the first dose of study drug and up to 30 days after receiving the last dose of study drug. Treatment-related TEAEs included TEAEs that were considered by the Investigator to be possibly or probably related to eribulin mesylate and/or doxorubicin/cyclophosphamide, or missing causality. Standardized Medical Dictionary for Regulatory Activities Queries (SMQ). | The Safety Analysis Set included all participants who were enrolled, received at least 1 dose of study treatments and had at least 1 post-treatment safety assessment. This was the primary analysis set for all safety evaluations including issues related to cyclophosphamide and doxorubicin (AC) or eribulin treatments. | Posted | Count of Participants | Participants | No | From date of first dose up to 30 days after the last dose of study treatment, or up to approximately 4 years 2 months |
|
|
|
| 3 |
| 55 |
| 6 |
| 55 |
| 55 |
| 55 |
| EG001 | Cohort 2: Eribulin Mesylate With Prophylactic Filgrastim | Participants initially received doxorubicin (60 mg/m^2) plus cyclophosphamide (600 mg/m^2) IV on Day 1, of every 14-day cycle for 4 cycles. Eribulin mesylate was administered following the doxorubicin plus cyclophosphamide regimen at a dose of 1.4 mg/m^2 IV over 2 to 5 minutes on Days 1 and 8 of a 21-day cycle for 4 cycles (Cycles 5 to 8). In this Cohort filgrastim was used with eribulin therapy at a dose of 300 micrograms for participants ≤60 kg or 480 micrograms for participants >60 kg, administered subcutaneously on Days 3 and 4 and Days 10 and 11 of each eribulin cycle. | 0 | 26 | 4 | 26 | 26 | 26 |
| Nausea | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Oesophagitis | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Mucosal inflammation | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Breast abscess | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
|
| Catheter site cellulitis | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
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| Genital herpes | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
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| Lung infection | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
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| Weight decreased | Investigations | MedDRA Version 17.1 | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Syncope | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Febrile neutropenia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Leukopenia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Neutropenia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Palpitations | Cardiac disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Tinnitus | Ear and labyrinth disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dry eye | Eye disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Lacrimation increased | Eye disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Flatulence | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Gatrooesophageal reflux disease | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Hemorrhoids | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Stomatitis | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Chills | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Fatigue | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Mucosal inflammation | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Oedema peripheral | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Pain | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Bronchitis | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
|
| Upper respiratory tract infection | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
|
| Vulvovaginal myotic infection | Infections and infestations | MedDRA Version 17.1 | Systematic Assessment |
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| Alanine immunotransferase increased | Investigations | MedDRA Version 17.1 | Systematic Assessment |
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| Weight decreased | Investigations | MedDRA Version 17.1 | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Joint stiffness | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Musculoskeletal chest pain | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Cognitive disorder | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Neuropathy peripheral | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Depression | Psychiatric disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Insomnia | Psychiatric disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Mood altered | Psychiatric disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dysuria | Renal and urinary disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nocturia | Renal and urinary disorders | MedDRA Version 17.1 | Systematic Assessment |
|
| Breast pain | Reproductive system and breast disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Menstruation irregular | Reproductive system and breast disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Vaginal discharge | Reproductive system and breast disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Vulvovaginal dryness | Reproductive system and breast disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Rhinorrhea | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Upper airway cough syndrome | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dry skin | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nail discoloration | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nail disorder | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nail ridging | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Onychalgia | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Onychomadesis | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Palmar-plantar erythrodysaethesia syndrome | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Pruritis | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Skin hyperpigmentation | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Hot flush | Vascular disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Hypertension | Vascular disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Lymphopenia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Gingival pain | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| D017437 |
| Skin and Connective Tissue Diseases |
| Eribulin-related TEAEs |
|
| Grade ≥3 TEAEs |
|
| SAEs |
|
| Alopecia |
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| Neutropenia (SMQ) |
|
| Peripheral neuropathy (SMQ) |
|