The EMBRACE trial demonstrated significantly improved survival with eribulin compared to physicians’ choice (13.1 vs 10.9 months (p = 0.041). Eribulin has been funded by the NHS in the UK for the management of locally advanced or metastastic breast cancer after at least two lines of treatment. We describe the UK experience of eribulin in this setting.
Data from 577 patients was analyzed on an individual patient basis from 14 different hospitals after institutional review board approval. Data was collected retrospectively using computerized records and chemotherapy records. Data was collated on: age, breast cancer characteristics, prior chemotherapy regimes, toxicity, PFS and OS. Statistical analysis was performed using SPSS.
Data from 577 patients who received eribulin in specialist cancer centres, teaching hospitals and cancer units throughout the UK between 2011-2017 were included. The median age of patients was 56 (33-84). 447 were ER positive, 129 triple negative, 100 patients were Her2 positive, 1 unknown. The cohort was heavily pre-treated with eribulin being received on average 4thline (median (range 2-11)). The median number of eribulin cycles received were 4 (range 1-29). The OS of the cohort was 288 days (95%CI 260-315), triple negative patients had a worse outcome than ER/Her2 expressing patients (198 c.f. 278 days (p = 0.02)). Less heavily pre-treated patients (≤2 prior treatments) had significantly better survival (328 c.f. 264 days). Patients aged over 65 had better survival 325 c.f. 285 days. 11% experienced grade 3-4 neuropathy, 14% experienced nausea, 19% experienced G3-4 neutropenia, there were no treatment related deaths.
This real world data demonstrates that even in a heavily pretreated population eribulin was associated an OS approaching a year. Eribulin was well tolerated even in patients over 65 and is associated with better survival if used earlier in metastatic patients.
M. Jafri: Advisory board: PharmaMar; Speaker fees: Roche, Pfizer, PharmaMar. H. Kristeleit: Advisory board: Amgen and Roche; Speaker fees: Eisai and Roche. S. Ahmed: Consultancy: Eisai, Novartis, Roche, Pfizer, MSD, AstraZeneca, Takeda. A. Borley: Consultancy: Eisai, Roche, Pfizer. P. Nightingale: Educational grant: Eisai for statistical support. D. Rea: Roche, Novartis, Diachi Sankyo, AstraZeneca, Eisai. All other authors have declared no conflicts of interest.