To analyze the efficacy of eribulin alone or combination therapy in different molecular subtypes of advanced breast cancer based on multicenter data.

This retrospective study collected clinical data of 184 patients with advanced breast cancer who received eribulin treatment between January 2021 and December 2024 at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (n=121), Beijing Chaoyang District Sanhuan Cancer Hospital (n=40), and Shenzhen Hospital of Cancer Hospital, Chinese Academy of Medical Sciences (n=23). According to molecular subtypes of breast cancer, it was classified into 4 groups: hormone receptor-positive (HR+) /HER-2- (n=88), HR+/HER-2+ (n=9), HR-/HER-2+ (n=11), and triple negative breast cancer (TNBC) (n=76). Based on treatments, patients were categorized into 3 groups: eribulin alone, combination with antiangiogenic agents, or combination with other chemotherapeutic agents. The primary endpoint was progression-free survival (PFS); secondary endpoint included objective response rate (ORR) and clinical benefit rate (CBR). The survival curve was plotted using the Kaplan-Meier method, and Log-rank method was used for survival analysis.

The median PFS of all 184 patients was 4.6 months (95%CI: 3.9–5.3), the ORR was 33.1% (61/184), and CBR was 82.6% (152/184). The median PFS of HR+/HER-2-, HR+/HER-2+, HR-/HER-2+, and TNBC were 5.0 (95%CI: 4.1-5.9), 4.1 (95%CI: 2.7-5.5), 3.5 (95%CI: 2.2-4.8), and 4.4 (95%CI: 3.6-5.3) months, respectively, with no statistically significant difference between the 4 groups (χ²=2.654, P>0.05); The ORRs were 39.8% (35/88), 22.2% (2/9), 36.4% (4/11), and 26.3% (20/76), respectively; The CBRs were 83.0% (73/88), 77.8% (7/9), 72.7% (8/11), and 84.2% (64/76), respectively. In the HR+/HER-2- group, the median PFS of 71 patients who had previously received cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) treatment was 5.3 months (95% CI: 4.4-6.3), with an ORR of 39.4% (28/71). The median PFS of patients receiving combination therapy with elibulin (n=121) and without antivascular therapy (n=63) were 4.5 months (95%CI: 3.8–5.2) and 4.9 months (95%CI: 3.4–6.5) respectively, with no statistically significant difference (χ²=1.693, P>0.05) . Among combination treatments, the median PFS of eribulin combined with bevacizumab, anlotinib, and apatinib were 4.4 (95%CI: 3.4–5.4) , 4.5 (95%CI: 3.6-5.4) , and 2.9 months, respectively, with no statistically significant difference (χ²=0.855, P>0.05) .

Eribulin alone or in combination therapy all have a certain anti-tumor activity in patients with advanced breast cancer of different molecular types (including CDK4/6i drug resistant HR+/HER-2- subtype) .