- Class: Microtubule dynamics inhibitor – non-taxane microtubule inhibitor
- Type: IV cytotoxic chemotherapy
Mechanism of Action (MOA)
- Synthetic analog of halichondrin B (natural product from marine sponge).
- Binds to microtubule plus ends, inhibiting polymerization.
- Leads to mitotic blockade at G2/M phase → apoptosis.
- Distinct from taxanes – does not stabilize microtubules but prevents elongation.
Clinical Uses
- Metastatic breast cancer – previously treated with at least 2 chemotherapeutic regimens, including anthracyclines and taxanes.
- Liposarcoma – unresectable or metastatic (soft tissue sarcoma).
Dosing (Adults)
- 1.4 mg/m² IV over 2–5 minutes on days 1 and 8 of a 21-day cycle.
- Dose adjustments:
- Hepatic impairment
- Severe neutropenia or thrombocytopenia
- No routine premedication; antiemetics as needed.
Toxicities
- Hematologic: neutropenia (dose-limiting), anemia, thrombocytopenia
- Neurologic: peripheral neuropathy (sensory, cumulative)
- Fatigue, alopecia
- Gastrointestinal: nausea, constipation
- Rare: febrile neutropenia, QT prolongation
Monitoring
- CBC prior to each dose
- Neurologic assessment for peripheral neuropathy
- Liver function tests
- ECG if patient at risk of QT prolongation
- Monitor for signs of infection
Summary
Eribulin (Halaven®) is a non-taxane microtubule inhibitor used in heavily pretreated metastatic breast cancer and liposarcoma. Key concerns are myelosuppression, peripheral neuropathy, and fatigue, requiring CBC monitoring, neurologic assessment, and liver function monitoring.
Synonyms
Halaven