Chemotherapy is one of the treatment options for patients with breast cancer, a malignant disease that mainly affects women. While the disease can be diagnosed in both genders, it affects about 230,000 new female patients as well as 2,300 males every year in the US, according to estimates from the American Cancer Society. Breast cancer patients often experience symptoms like a new breast lump or mass, swelling of all or part of a breast, skin irritation or dimpling, breast or nipple pain, nipple retraction, redness, scaliness, or thickening of the nipple or breast skin, and nipple discharge other than breast milk.

When the diagnosis is confirmed, a treatment plan is developed by an oncology health care team, depending on the patient’s and tumor’s characteristics. While surgery and radiation are classified as local treatments, given their ability to treat the cancer without affecting the rest of the body, systemic treatments such as chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy, are focused on the use of drugs to reach cancer cells anywhere in the body.

How Eribulin (Halaven) Works

Eribulin is a chemotherapy classified as a non-taxane microtubule dynamics inhibitor, which is a type of drug that interferes with the tubular system in order to prevent the cancer cells from dividing into two new cells, consequently blocking cancer growth. Despite the fact that the most common cancer drugs are taxanes that act on the DNA, the expected results are similar. Eribulin is also a synthetic analogue of halichondrin B, a product isolated from the marine sponge Halichondria okadai. The drug is used for the treatment of breast cancer and a type of soft tissue sarcoma called liposarcoma that cannot be surgically removed or that has metastasized.

“The mesylate salt of a synthetic analogue of halichondrin B, a substance derived from a marine sponge (Lissodendoryx sp.) with antineoplastic activity. Eribulin binds to the vinca domain of tubulin and inhibits the polymerization of tubulin and the assembly of microtubules, resulting in inhibition of mitotic spindle assembly, induction of cell cycle arrest at G2/M phase, and, potentially, tumor regression,” classified the National Cancer Institute (NCI) Drug Dictionary.

Eribulin (Halaven) for Breast Cancer

Eribulin was approved by the US Food and Drug Administration (FDA) on November 15, 2010, and it is commercialized under the brand name Halaven™  Injection, by Eisai Inc. The chemotherapy drug is indicated for patients with metastatic breast cancer who have previously received an anthracycline and a taxane in either the adjuvant or metastatic setting and at least two chemotherapeutic regimens for the treatment of metastatic disease. “The approval is based on results from a phase III international multicenter open-label randomized clinical trial, Study E7389-G000-305 (EMBRACE trial),” explain the National Cancer Institute.

“This trial demonstrated a statistically significant improvement in overall survival (OS) in patients receiving eribulin compared with those receiving a single-agent therapy selected by their physician.” The dosage used in the study was 1.4 mg/m2 of eribulin on days 1 and 8 of a 21-day cycle, with dose delays and reductions for pre-specified toxicities. The investigation also found adverse events associated with the treatment, being the most common neutropenia, anemia, asthenia/fatigue, alopecia, peripheral neuropathy, nausea, and constipation, which affected at least 25% of patients.

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