Systematic review of Real-World effectiveness of eribulin for locally advanced or metastatic breast cancer

Abstract

Background

Eribulin mesylate (eribulin) is indicated for patients with metastatic breast cancer (MBC) who have previously received at least two chemotherapies in the US and for patients with locally advanced breast cancer (LABC) or MBC who have progressed after at least one chemotherapy in the European Union (EU). In both indications, prior therapy should include an anthracycline and a taxane in adjuvant or metastatic setting. Numerous studies evaluated eribulin in real-world (RW) breast cancer populations to reinforce its consistent effectiveness beyond registration randomized controlled trials (RCTs) that reported median overall survival (OS) of 13.1 and 15.9 months. In this systematic literature review (SLR), we summarize the cumulative evidence on eribulin’s RW effectiveness in LABC/MBC.

Methods

We searched through Medline/PubMed and Embase databases between 2012 and 2019 for articles reporting RW eribulin use in the second- or third-line or later LABC/MBC setting. Because eribulin showed greatest OS benefits in triple negative breast cancer (TNBC) in RCTs, we also reviewed this tumor subtype. OS and progression-free survival (PFS) were the effectiveness outcomes of interest.

Results

Overall, 34 journal articles or abstracts met the selection criteria. Median OS ranged between 6.9 and 28.0 months; median PFS varied from 2.3 to 14.7 months. Eight studies reported OS outcomes for TNBC patients, and median OS ranged between 3.0 and 23.0 months.

Conclusion

The SLR showed high variability in OS and to a lesser extent in PFS associated with eribulin use in RW setting. Despite heterogeneity in line of use and patient subtypes, this SLR supports effectiveness of eribulin for LABC/MBC in clinical practice.

Keywords:

• Advanced breast cancer
• chemotherapy
• effectiveness
• eribulin
• metastatic breast cancer
• overall survival
• progression-free survival
• real-world
• systematic review
• triple-negative breast cancer

Transparency

Declaration of funding

This study was funded by Eisai Inc., Woodcliff Lake, NJ, USA.

Declaration of financial/other relationships

Isabelle Chabot was a contractual consultant for Eisai Inc. when she conducted this systematic literature review. Qi Zhao and Yun Su were both employees of Eisai Inc. when this SLR was conducted. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Acknowledgements

None stated.