Treatment options for anthracycline-resistant, advanced soft-tissue sarcoma: the role of eribulin

Abstract

ABSTRACTIntroduction: Soft-tissue sarcomas (STS) are a diverse group of rare mesenchymal malignancies. Treatment options for advanced STS following failure of first-line chemotherapy remain limited.Areas covered: Summary of established second- or later-line regimens for advanced STS and a discussion of clinical evidence in support of eribulin use, focused on the treatment of liposarcomas and leiomyosarcomas (L-sarcomas).Expert opinion: Current evidence supporting a role for specific second-line agents in different histologic subtypes of STS is limited, but a more defined treatment landscape is emerging. Strong scientific evidence from phase 3 trials has been shown for eribulin, trabectedin, dacarbazine, and pazopanib after failure of anthracyclines. In particular, eribulin is the first systemic monotherapy to show a significant improvement in overall survival against an active comparator in a phase 3 trial in patients with advanced L-sarcomas. Eribulin is approved for the treatment of unresectable or metastatic liposarcoma in patients who have received a prior anthracycline-containing regimen. Eribulin has also demonstrated clinical activity in patients with leiomyosarcoma in phase 2 and phase 3 trials. Further studies are needed to determine optimal treatment and sequence of agents after failure of anthracyclines. Future trials should aim to be subtype specific as treatment outcomes are dependent on tumor histology and genetic profile.