Uterine
leiomyosarcoma is a rare type of malignant gynecological
tumor and has a poor prognosis; therefore, this
tumor is often difficult to treat. Some new drugs have been approved during the past several years in Japan and are expected to be efficacious.
Eribulin, one of these drugs, is a
natural product of
halichondrin B, which is isolated from a marine sponge. A recent clinical trial comparing
eribulin with
dacarbazine to target
liposarcoma and
leiomyosarcoma indicated that overall survival (OS) was prolonged by treatment with
eribulin. We report a case of uterine progressive
leiomyosarcoma that responded to
eribulin. A 57-year-old woman was suspected of having
leiomyosarcoma based on an endometrial biopsy and imaging examinations. Although the
tumor grew toward the uterine artery on the right side of the uterine cervix, we performed a total abdominal
hysterectomy and bilateral
salpingo-oophorectomy to obtain an outcome of no gross residual disease. However, the margin of the right side of the uterine cervix was histologically positive, so
leiomyosarcoma stage IIB (pT2bcN0cM0, FIGO2008) was diagnosed.
Gemcitabine and
docetaxel therapy was administered postoperatively. However, after three cycles, the
residual tumor progressed. Other anticancer drugs were administered but were ineffective. We administered
eribulin (1.4 mg/m2) as a fourth-line regimen, and the mass decreased by 32% after four cycles. However, the
residual tumor continued to grow after eight cycles. The only adverse event associated with
eribulin treatment was mild, grade 2
neutropenia. For our patient,
eribulin was effective for her recurrent
leiomyosarcoma. In selecting
chemotherapy, there are currently no fixed guidelines; we should consider the characteristics and adverse events associated with each
drug and patient performance status and comorbidities. In this patient,
eribulin was associated with few adverse events, an easy route of administration and a good quality of life. Therefore,
eribulin is expected to be efficacious for the treatment of gynecologic
sarcoma.