Eribulin for advanced breast cancer: Clinical experience in the real world.

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e12003 Background: A number of cytotoxic agents are used for the treatment of advanced breast cancer. Benefit beyond 2 lines of palliative chemotherapy remains poor. Eribulin is a new IV cytotoxic agent that inhibits microtubule dynamics, blocking mitosis irreversibly thus leading to an anticancer effect. The EMBRACE study demonstrated improvement in overall survival (OS) in patients treated with Eribulin when compared to treatment of physician choice, following at least 2 lines of prior treatment. We present response, OS and toxicity data on a cohort of patients treated at our institution with eribulin. Methods: 75 patients treated with eribulin from August 2011 to March 2013 were identified and the electronic patient notes and chemotherapy prescribing system were used to acquire data. Results: 75 patients, median age 53 years (range 40-79) had one or more cycles of eribulin. 23 (31%) had single site metastasis, 48 (64%) had multiple sites. Data unavailable for 4 patients. 70% of patients had ≤3 previous lines of chemotherapy for metastatic disease (range 0-6). 85% had previous capecitabine. Median number of cycles of eribulin was 6; 23 (30.6%) had ≤ 3 cycles, 20 (26.7%) 4 - 6 cycles, 13 (17.3%) 7 - 10 cycles, 19 (25.3%) ≥ 10 cycles. 65 (86.7%) had response assessed radiologically; 56 of who were assessed after cycle 3. At first assessment, 36 (55%) had stable disease, 13 (20%) partial response, 16 (25%) progressive disease. 34 (45%) patients were still alive at time of analysis, with median OS of 11.7 months (range 16 to 742 days) from start of eribulin. The most commonly reported toxicities were lethargy, neuropathy and nausea (55%, 33% and 32% respectively). Neutropenia was reported in 17% of patients, leading to 8 admissions and 1 death due to neutropaenic sepsis. 5 patients had 2 or more admissions during their course of treatment, none more than 3 admissions. We are analysing data further to look at outcomes within subgroups such as receptor status and previous lines of treatment. Conclusions: Our patients achieved a high response rate and OS comparable to the EMBRACE OS of 13.2 months, with an expected and manageable level of toxicity. We have demonstrated effectiveness and safety of this drug in the real world, mirroring findings of the pivotal phase III RCT EMBRACE.

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