Postoperative adjuvant eribulin in high-risk patients with soft tissue sarcoma: A retrospective study of eight cases

Background The role of perioperative chemotherapy in localized soft tissue sarcomas (STS) remains controversial, particularly in older adult patients and those with considerable comorbidities who may not tolerate anthracycline-based regimens. Although eribulin has demonstrated efficacy and safety in advanced STS, its use as a postoperative adjuvant treatment has not been well documented. Objective To evaluate the feasibility, safety, and clinical outcomes of postoperative adjuvant eribulin administration in patients with localized STS, with a focus on older adults and patients with comorbidities. Methods We conducted a single-institution retrospective study of a case series of patients with localized STS who had undergone surgical resection with curative-intent, followed by postoperative adjuvant eribulin administration. Data on patient characteristics, treatment administration, adverse events, and oncological outcomes were obtained from the medical records. Adverse events were graded based on the Common Terminology Criteria for Adverse Events. Results Eight patients, most of whom were older adults or had substantial comorbidities, were included in the study. Postoperative eribulin therapy was initiated in all patients. Hematological toxicities, including neutropenia and leukopenia, were relatively common, but manageable with dose modification and supportive care. Non-hematological toxicities, such as peripheral neuropathy and dysgeusia, were generally mild to moderate. No treatment-related deaths or clinically significant cardiac adverse events were observed. Six patients remained continuously disease-free during follow-up, whereas two died of the disease. Conclusions Postoperative adjuvant eribulin therapy was feasible and well-tolerated in a high-risk population of patients with localized STS. Although its efficacy cannot be determined from this small case series, its favorable safety profile suggests that eribulin may be a viable treatment option for patients who are poor candidates for anthracycline-based perioperative chemotherapy. Further studies are warranted to clarify its role in perioperative treatment strategies for STS.