Halaven

Indications

Eribulin Mesylate is a chemotherapy medicine used to treat breast cancer that has spread (metastatic) or is locally advanced and has continued to grow after at least one earlier chemotherapy for advanced disease, usually including an anthracycline and a taxane. It is also used for liposarcoma (a soft tissue cancer) that cannot be removed by surgery, after earlier chemotherapy.

How It Works

Eribulin is based on a substance originally found in a sea sponge. It blocks the growth of microtubules, the tiny tube-like structures that cells need to divide. Cancer cells that cannot divide properly stop growing and die. It may also change the environment around the tumour in ways that make it less able to spread.

Dosage and Administration

Eribulin is given only in hospital or a cancer clinic by a doctor or nurse, as a short injection into a vein over a few minutes, usually on certain days of a repeating treatment cycle. The dose is calculated from body surface area and adjusted for blood counts, liver and kidney function, and nerve side effects, exactly as prescribed by the oncologist. It must not be diluted in glucose solutions.

Interactions

• Medicines that prolong the QT interval on the heart tracing (such as Amiodarone, Haloperidol, Ondansetron at high doses, some antibiotics like Clarithromycin) may increase the risk of heart rhythm problems
• Live vaccines should be avoided during treatment
• Tell the doctor about all other medicines and supplements

Contraindications

• Allergy to Eribulin or any ingredient
• Breastfeeding

Side Effects

Very common effects include low white blood cells (raising the risk of infection), tiredness and weakness, hair loss, numbness, tingling or pain in the hands and feet (peripheral neuropathy), nausea, constipation, diarrhoea, loss of appetite, joint and muscle pain, fever and low red blood cells. Changes in heart rhythm (QT prolongation), mouth sores and liver test changes may also occur.

Get urgent medical help for fever of 38°C or above, chills or other signs of infection, difficulty breathing, chest pain, a fast or irregular heartbeat, fainting, severe diarrhoea or vomiting, or worsening numbness or weakness.

Pregnancy and Lactation

Eribulin can harm an unborn baby. Women who could become pregnant must use effective contraception during treatment and for the period after the last dose advised by the doctor (usually several months); men with female partners should also use contraception during treatment and for several months afterwards, as advised. Do not breastfeed during treatment. It may affect fertility in men, who may consider sperm storage beforehand.

Precautions and Warnings

Blood counts are checked before each dose. Use with care in liver or kidney disease, heart rhythm problems, and low potassium or magnesium, which should be corrected before treatment. Report numbness or tingling early. Avoid driving if you feel tired or dizzy.

Overdose

Overdose mainly causes severe lowering of white blood cells. There is no specific antidote; the patient is monitored closely and given supportive care.

Therapeutic Class

Antineoplastic; microtubule inhibitor (halichondrin B analogue).

Storage

Store below 30°C, do not freeze, and keep the vial in the outer carton. Hospital storage as directed on the pack.