Long-term efficacy of eribulin in patients with advanced myxoid liposarcoma resistant to trabectedin: A case report

Kazuma Arai , Koichi Okajima , Yuki Ishibashi , Yusuke Tsuda , Shinji Kohsaka , Yoichi Yasunaga , Kohichi Takada , Makoto Emori , Tetsuo Ushiku , Katsutoshi Oda , Kiyoshi Miyagawa , Hiroyuki Aburatani , Hiroyuki Mano , Sakae Tanaka , Hiroshi Kobayashi
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Abstract

Background

Myxoid liposarcoma is sensitive to trabectedin, but less sensitive to eribulin.

Case presentation

A 47-year-old man presented to our hospital with a right leg mass, biopsy of which revealed myxoid liposarcoma. Surgical resection was performed and perioperative chemotherapy was administered. Eighteen years postoperatively, the patient developed pericardial metastasis causing cardiac tamponade, and radiotherapy was administered. One year later, mesenteric metastasis occurred and the tumor was resected. One year later to this, multiple metastases, including recurrent mesenteric metastases, occurred. As the metastases progressed after two cycles of trabectedin treatment, eribulin was initiated, resulting in a partial response. Eribulin was continued for 18 months without severe adverse events. Genetic testing of the resected mesenteric tumor revealed a PIK3CA (p.H1047R) mutation, and immunohistochemistry for phosphorylated AKT was negative.

Conclusions

This report of long-term successful treatment of trabectedin-resistant myxoid liposarcoma with eribulin suggests sensitivity mechanism to eribulin in myxoid liposarcoma with PIK3CA mutation.
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伊瑞布林治疗耐药晚期黏液样脂肪肉瘤的长期疗效:1例报告
背景:黏液样脂肪肉瘤对单链蛋白敏感,但对伊瑞布林不太敏感。病例介绍:一名47岁男性因右腿肿块就诊,活检显示黏液样脂肪肉瘤。手术切除,围手术期化疗。术后18年,患者出现心包转移引起心包填塞,并给予放疗。一年后发生肠系膜转移,切除肿瘤。一年后,出现多发性转移,包括复发性肠系膜转移。在trabectedin治疗两个周期后,随着转移的进展,开始使用eribulin,导致部分反应。艾力布林持续治疗18个月,未发生严重不良事件。切除的肠系膜肿瘤基因检测显示PIK3CA (p.H1047R)突变,磷酸化AKT免疫组化阴性。结论伊立布林长期成功治疗耐小檗碱的黏液样脂肪肉瘤,提示PIK3CA突变的黏液样脂肪肉瘤对伊立布林的敏感性机制。
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