Clinical outcome of 50 patients treated with eribulin for soft tissue sarcoma: a single-institute retrospective study

Eribulin is an approved treatment option for soft tissue sarcomas (STSs) in Japan; however, real-world data regarding its safety, efficacy, and optimal dosing strategies across heterogeneous patient populations remain limited. Thus, this study aimed to evaluate clinical outcomes, treatment tolerability, and prognostic factors in patients with STS treated with eribulin.

We retrospectively reviewed 50 patients with STS who received eribulin at a single institution between 2018 and 2024. Clinical variables, dosing schedules, tumor responses, survival outcomes, and adverse events (AEs) were analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method; group comparisons were performed with the log-rank test.

The cohort had a median age of 66 years, and eribulin was administered as first-line therapy in 24 patients. The disease control rate was 62%; one patient achieved complete response and one achieved partial response. Median PFS and OS were 4 and 19 months, respectively. Hematologic toxicities were the most common Grade ≥ 3 AEs, with no treatment-related cardiac events observed. Dose modifications included a bi-weekly schedule or a regimen consisting of two administrations followed by a 2-week rest period with pegfilgrastim support. No treatment discontinuations due to AEs occurred in either reduced-intensity schedule; the latter regimen demonstrated the longest treatment duration. Survival outcomes were comparable across age groups, treatment lines, histological subtypes, and tumor locations. Patients aged ≥70 years achieved a median OS of 16 months, generally consistent with previously reported outcomes in elderly sarcoma populations.

Eribulin demonstrated favorable tolerability and durable disease control across diverse patient subgroups, including elderly and comorbid patients who are often ineligible for anthracycline therapy. Although no significant prognostic factors were identified, bi-weekly dosing and two-administration/2-week rest schedules were feasible, with the latter offering the advantage of pegfilgrastim support. These findings support the integration of eribulin into individualized treatment strategies for advanced STS and highlight the need for prospective studies to refine patient selection and optimize dosing approaches.