Halaven (eribulin) is a chemotherapy that’s used to treat cancers, such as metastatic breast cancer and liposarcoma (a type of soft tissue cancer). The medication is given as an infusion through the vein (IV) on days 1 and 8 of 21-day treatment cycles. It only takes about 2 to 5 minutes to infuse. Often, Halaven (eribulin) causes low blood cell counts that can lead to fatigue and a risk for infections.
Metastatic breast cancer after trying at least 2 previous treatments for metastatic disease
Advanced or metastatic liposarcoma after trying anthracycline-based chemotherapy
Halaven (eribulin) is a microtubule inhibitor. Microtubules are small, tube-like parts in cells that help cells grow. Halaven (eribulin) works by stopping microtubules in the body’s cells from working. When the medication blocks the microtubules in cancer cells, the cells can’t grow as easily and can die off.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Short infusion lasting 2 to 5 minutes
Given every 1 to 2 weeks
Recommended option for metastatic breast cancer and liposarcoma when previous treatment has stopped working
Given as an infusion through the vein
Can cause fatigue and hair loss
Can put you at higher risk for infections
Before each Halaven (eribulin) infusion, you’ll get blood tests to make sure it’s safe for you to get treatment. Your provider might lower your dose or hold treatment if your liver or kidneys aren’t working well or your blood cell counts are too low; these situations put you at risk of harm.
Halaven (eribulin) can cause a drop in your red blood cell count, leading to anemia and fatigue. The medication can also lower your platelet counts and make it harder for blood to clot. If they drop too low, you might need blood or platelet transfusions.
You might be at higher risk for infections because you can have fewer white blood cells than usual while you’re getting treated with Halaven (eribulin). It’s a good idea to avoid sick people, wash your hands often, and let your healthcare team know if you have a fever or are feeling ill.
It’s common to have hair loss while you’re taking Halaven (eribulin). Some people prefer to cut their hair shorter before their hair falls out. Wigs, hats, scarves, and turbans are also options you can use as accessories.
Pain, numbness, and tingling in your hands or feet is a common Halaven (eribulin) side effect. Talk with your provider about strategies to manage your symptoms if they start negatively impacting your daily life.
If you can become pregnant, you’ll need to use effective birth control while you’re receiving treatment and for at least 2 weeks after your last dose. If you’re male and have partners who can become pregnant, make sure to use a condom if you have sex during treatment and at least 3.5 months after the last dose. These safety measures are important because Halaven (eribulin) can harm unborn babies.
If you’re nursing a baby, avoid breastfeeding during treatment and for 2 weeks after the last dose. We don’t know how Halaven (eribulin) affects milk supply and whether it’s safe for your baby because there are no studies about this yet.
Halaven (eribulin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Liver problems
Halaven (eribulin) can lower the amount of white blood cells you have and cause neutropenia. This can raise your risk for infections that could be fatal. Usually, you’re at the most risk when your infection-fighting cells are at their lowest (a time point called nadir). In studies of people taking Halaven (eribulin), the average time to nadir was about 13 days of each treatment cycle.
Let your healthcare team know if you’re feeling ill or have signs of infection such as a fever, chills, cough, or pain or burning when urinating. Your provider will check your blood cell counts before each of your Halaven (eribulin) infusions. If you have an infection or your provider notices you have a low white blood cell count, your provider might recommend injections to help boost up your white blood cells. They might also adjust your Halaven (eribulin) dose.
Halaven (eribulin) can cause discomfort, pain, numbness, and tingling in the hands and feet. This is a nerve problem called peripheral neuropathy. In studies, some people started having these symptoms during the first 5 months of treatment, and symptoms could linger for months. Talk with your provider if you have these nerve symptoms and they’re disrupting your daily activities. They can recommend ways to help with your symptoms. They might also lower the Halaven (eribulin) dose or give you a longer break between infusions to help relieve your side effects.
Risk factors: Heart failure | Previous abnormal heart rhythms | Taking medications that can affect heart rhythm | Electrolyte abnormalities
Halaven (eribulin) can cause changes to your heart’s electrical activity called QT prolongation. This can affect your heart rhythm, which can sometimes be serious or life-threatening. Your risk for QT prolongation depends on your genetics, your electrolyte levels, and whether you’re taking other medications that can also affect your heart rhythm. According to a small study, this problem can occur by the time you get your second dose of Halaven (eribulin) in your treatment cycle.
Your provider will check your blood electrolyte levels before starting Halaven (eribulin) and regularly during treatment. And if you have risk factors for QT prolongation, your provider might also order an electrocardiogram (EKG) to monitor your heart’s electrical activity. Share a complete list of the medications and supplements you take with your healthcare team so they can check your risk for heart rhythm problems. Tell your provider right away if you notice new pounding or fluttering heartbeat, lightheadedness, dizziness, or chest pain during treatment.
Based on findings from animal studies and the way the medication works, Halaven (eribulin) can cause harm to unborn babies. If you’re pregnant or think you might be pregnant, talk with your provider before starting treatment with Halaven (eribulin).
Use reliable birth control while you’re taking the medication and for at least 2 weeks after the last dose if you’re able to become pregnant. And if you’re male and have a partner who can have children, you must use condoms when you have sex while you’re getting treated with Halaven (eribulin) and for 3.5 months after your last dose.
The typical dose will be based on your body surface area (BSA, measured in units of m2), which takes into account your height and weight.
Usually, the dose is 1.4 mg/m2 given as an infusion through the vein (intravenously or IV). It’s given on days 1 and 8 of each 21-day cycle of treatment (in other words, once a week for 2 weeks, then repeated after a week break).
Your dose might be lower if your liver or kidneys aren’t working well. You might also need a lower dose if you have side effects from the medication.
Metastatic breast cancer after trying at least 2 previous treatments for metastatic disease
Advanced or metastatic liposarcoma after trying anthracycline-based chemotherapy
Advanced or metastatic breast cancer:
Advanced or metastatic bladder cancer, after certain treatments stop working
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American Cancer Society. (2020). Coping with hair loss.
American Cancer Society. (2021). Managing peripheral neuropathy.
British Society for Cell Biology. (n.d.). Cytoskeleton – the movers and shapers in the cell.
Cancer.net. (2019). Neutropenia.
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Centers for Disease Control and Prevention. (n.d.). What you need to know: Neutropenia and risk for infection.
Eisai Inc. (2022). Halaven- eribulin mesylate injection [package insert]. DailyMed.
Farzam, K., et al. (2023). QT prolonging drugs. StatPearls.
MedlinePlus. (2023). Low white blood cell count and cancer.
National Comprehensive Cancer Network. (2023). Metastatic breast cancer.
National Comprehensive Cancer Network. (2023). Soft tissue sarcoma.
National Organization for Rare Disorders. (2023). Liposarcoma.
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