Eribulin and Trabectedin Yield Comparable Real-World OS Outcomes in Advanced Liposarcoma

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Treatment with eribulin mesylate (Halaven) generated overall survival (OS) outcomes similar to those seen with trabectedin (Yondelis) treatment in patients with locally advanced or metastatic liposarcoma who had previously been treated with doxorubicin, according to findings from a real-world efficacy comparison, which were presented at the 2025 ESMO Sarcoma and Rare Cancers Annual Congress.1

The study, which used real-world-data from the TriNetX platform, showed that the median OS with eribulin (n = 558) was 347 days, and the median OS with trabectedin (n = 558) was 401 days (post-propensity score matching HR, 0.955; 95% CI, 0.820-1.112; P = .614). The survival probabilities at the end-of-time window were 0.00% and 3.41% in the trabectedin- and eribulin-treated populations, respectively.

“The median OS in both arms are near identical,” presenting author Jesús Rodríguez Pascual, MD, PhD, stated in the presentation. “We cannot find any difference in the treatment with crossover or without crossover for treatment.”

Pascual is the head of service at the Instituto Oncológico Vithas in Madrid, Spain.

Study Background and Rationale

Eribulin and trabectedin are both standard-of-care therapies for patients with advanced liposarcoma who have previously received doxorubicin-based therapy. Eribulin was FDA approved in 2016 based on findings from the liposarcoma cohort (n = 143) of a phase 3 trial (NCT01327885), in which the agent elicited a median OS of 15.6 months (n = 71; 95% CI, 10.2-18.6)) vs 8.4 months (95% CI, 5.2-10.1) with dacarbazine (n = 72; HR, 0.51; 95% CI, 0.35-0.75).2,3 Furthermore, the median progression-free survival (PFS) in these respective arms was 2.9 months (95% CI, 2.6-4.8) vs 1.7 months (95% CI, 1.4-2.6; HR, 0.52 [95% CI, 0.35-0.78]).3

Trabectedin was FDA approved in 2015 for the treatment of patients with unresectable or metastatic liposarcoma or leiomyosarcoma based on findings from the phase 3 ET743-SAR-3007 trial (NCT01343277), in which patients with soft tissue sarcoma who received trabectedin (n = 345) achieved a median OS of 13.7 months vs 13.1 months among those who received dacarbazine (n = 173; HR, 0.93; 95% CI, 0.75-1.15; P = .49).4 The median PFS in these respective populations was 4.2 months (95% CI, 3.0-4.8) vs 1.5 months (95% CI, 1.5-2.6; HR, 0.55 [95% CI, 0.44-0.70; P < .001]).

Currently, no head-to-head studies have compared eribulin vs trabectedin in this patient population.1

“Advanced liposarcoma is an infrequent disease,” Pascual noted. “We focused on real-world data and used it to help to clarify the importance of eribulin and trabectedin in this scenario.”

TriNetX is a global collaborative network platform that uses anonymized, aggregate clinical data from 140 health care organizations.

Study Design and Future Implications

This study included patients with advanced liposarcoma who were previously treated with doxorubicin-based therapy in the neoadjuvant, adjuvant, or palliative settings. Patients were not included if they had received crossover therapy with trabectedin after eribulin or vice versa. Investigators used propensity score matching to balance controls based on age, race, and gender.

Overall, 1828 patients from 128 health care organizations in the TriNetX platform were identified. In total, 1240 patients had received treatment with trabectedin, and 558 had been treated with eribulin. After propensity score matching, this study included 558 patients who had received trabectedin and 558 patients who had received eribulin.

“To date, this is the largest face-to-face comparison between these 2 therapeutic options. We are assured that focusing on real-world data can help to explore unanswered questions in the treatment of [patients with] advanced sarcoma,” Pascual concluded.

Disclosures: Pascual reported no conflicts of interest.

References

1. Pascual JR, Ugidos L, Rodriguez-Castaño JD, et al. Eribulin (E) versus trabectedin (T) therapy in patients with advanced liposarcoma: efficacy comparison using real-world data evidence from TriNetX platform. ESMO Open. 2025;10(suppl 3):104378. doi:10.1016/j.esmoop.2025.104378
2. FDA approves first drug to show survival benefit in liposarcoma. FDA. January 28, 2016. Accessed March 24, 2025. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-show-survival-benefit-liposarcoma
3. Halaven. Prescribing information. Eisai Inc. Updated September 2022. Accessed March 24, 2025. https://www.halaven.com/hcp/-/media/Files/Halaven/HALAVEN-Full-Prescribing-Information.pdf?&hash=4292bfe6-3c3f-4716-8f44-e2f2949229c8
4. U.S. FDA approves Yondelis (trabectedin) for the treatment of patients with unresectable or metastatic liposarcoma or leiomyosarcoma, two common subtypes of soft tissue sarcoma. News release. Janssen Biotech, Inc. October 23, 2015. Accessed March 24, 2025. https://www.jnj.com/media-center/press-releases/us-fda-approves-yondelis-trabectedin-for-the-treatment-of-patients-with-unresectable-or-metastatic-liposarcoma-or-leiomyosarcoma-two-common-subtypes-of-soft-tissue-sarcoma