Eribulin — Drug Monograph

Brand names: Halaven

Drug class: Other

Mechanism of Action

Eribulin is a synthetic analogue of halichondrin B that acts as a microtubule inhibitor with a unique mechanism. It inhibits the growth phase of microtubules without affecting the shortening phase and sequesters tubulin into nonproductive aggregates. This differs from other microtubule-targeted agents like taxanes or vincas, as it suppresses microtubule polymerization at the plus ends. This leads to an irreversible mitotic block in the G2/M phase and subsequent apoptosis.

FDA Indications

• For the treatment of patients with metastatic breast cancer who have previously received at least two chemotherapeutic regimens for the treatment of metastatic disease. Prior therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting.
• For the treatment of patients with unresectable or metastatic liposarcoma who have received a prior anthracycline-containing regimen.

Common Side Effects

• Neutropenia
• Anemia
• Asthenia/Fatigue
• Alopecia
• Nausea
• Peripheral neuropathy
• Constipation
• Arthralgia/Myalgia

Clinical Pearl

Eribulin is often favored in the late-line setting because of its very short infusion time (2-5 minutes) and lack of mandatory premedications. Unlike many other chemotherapies, it has shown an overall survival benefit in heavily pre-treated metastatic breast cancer patients. Monitor for peripheral neuropathy, as it is cumulative and may require dose delay or reduction if it reaches Grade 3.

Related Therapies & Mechanisms

• Capivasertib (Truqap) — Other · Breast
• Elacestrant (Orserdu) — Other · Breast
• Everolimus (Afinitor) — Other · Breast
• Nirogacestat (Ogsiveo) — Other · Sarcoma