Real-world effectiveness of eribulin in heavily pretreated patients with metastatic breast cancer in China: a multicenter retrospective study

Yannan Zhao, Ning Xie, Wei Li, Wenyan Chen, Zheng Lv, Yabing Zheng, Tao Sun, Jieqiong Liu, Jian Zhang, Shihui Hu, Yajun Wang, Chengcheng Gong, Yi Li, Yizhao Xie, Rui Ge, Fei Xu, Biyun Wang, Yannan Zhao, Ning Xie, Wei Li, Wenyan Chen, Zheng Lv, Yabing Zheng, Tao Sun, Jieqiong Liu, Jian Zhang, Shihui Hu, Yajun Wang, Chengcheng Gong, Yi Li, Yizhao Xie, Rui Ge, Fei Xu, Biyun Wang

Abstract

Background: Eribulin is a nontaxane microtubule inhibitor approved in China for patients with advanced breast cancer who show progression after ⩾2 lines of chemotherapy. The aim of this study was to determine the efficacy and safety profile of eribulin and explore potential predictive factors for the efficacy of eribulin among Chinese women with metastatic breast cancer (MBC) in real-world practice.

Patients and methods: A total of 272 consecutive MBC patients who were treated with eribulin between November 2019 and October 2020 in 9 institutions nationwide were included in this study. Eribulin was administered intravenously at a dose of 1.4 mg/m2 on days 1 and 8 of a 21-day cycle. Efficacy outcomes included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and clinical benefit rate (CBR). Adverse events (AEs) were graded according to The National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 5.0.

Results: Eribulin showed a median PFS of 4.1 months (95% confidence interval [CI] 3.6-4.6); however, the OS data were immature. The ORR was 17.6% and the CBR was 24.6%. A total of 51.8% of patients received eribulin monotherapy, while 48.2% of patients were treated with eribulin plus targeted therapy or other chemotherapy. The number of metastatic sites, duration of previous taxane treatment for MBC, and combination with bevacizumab were significant in Cox multivariate analysis (p = 0.023, p = 0.048, and p = 0.046, respectively) and were significantly associated with PFS of eribulin. The most common AEs with eribulin treatment were hematological toxicities, including neutropenia, leukopenia, and anemia.

Conclusion: Eribulin was effective with a manageable toxicity profile in clinical practice. Furthermore, when prescribed in combination with other agents, eribulin did not increase the toxic effects of each agent. Eribulin monotherapy or plus other agents is an alternative for the heavily pretreated patients with MBC.

Keywords: Chinese women; eribulin; metastatic breast cancer; predictive factors; real-world effectiveness.

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

© The Author(s), 2021.

Figures

Figure 1.
Figure 1.
Kaplan–Meier plot for PFS and OS in patients treated with eribulin. (a) Kaplan–Meier plot for PFS; (b) Kaplan–Meier plot for OS. OS, overall survival; PFS, progression-free survival.
Figure 2.
Figure 2.
Kaplan–Meier curves for PFS according to potential predictive factors. (a) Number of metastatic sites, (b) Combination with bevacizumab, (c) Duration of previous taxane treatment for MBC. CI, confidence interval; MBC, metastatic breast cancer; PFS, progression-free survival.

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