Eribulin mesylate is a halichondrin B analogue that acts as a nontaxane microtubule
dynamics inhibitor. Eribulin was approved in the United States in 2010 for the treatment
of metastatic breast cancer for patients who have received at least 2 metastatic breast
cancer chemotherapeutic regimens, including an anthracycline and a taxane. Eribulin
is administered as a single agent at 1.4 mg/m2 IV for 2 to 5 minutes on days 1 and 8 of a 21-day cycle.
The goals of this article are to review eribulin's medication profile, including pharmacology,
pharmacokinetic properties, efficacy, and tolerability. Recommendations are provided
at the end of the article based on the published information.
PubMed, the Cochrane Central Register of Controlled Trials, and Clinical Trials.gov
were searched from the beginning of each database through January 3, 2012, for relevant
articles on human studies published in English. Search terms included eribulin
, eribulin mesylate
, and Halaven
. Clinical trials, case reports, comparative studies, meta-analyses, evaluation studies,
controlled clinical trials, and randomized controlled trials were included as search
limits. The references from selected articles were also reviewed to identify additional
publications. Eisai, the manufacturer of eribulin mesylate, was also contacted for
information regarding trials listed in Clinicaltrials.gov
but not yet published.
One Phase III trial was identified that evaluated eribulin for use in patients with
metastatic breast cancer. Four Phase II trials were identified that studied eribulin
in patients with head and neck, pancreatic, and non–small cell lung cancers. The median
overall survival among previously treated metastatic breast cancer patients treated
with eribulin was 13.1 months compared with 10.6 months (P = 0.041) with other active chemotherapy for this setting. In non–small cell lung
cancer, median overall survival in eribulin-treated patients has been reported as
9.4 months in an unselected population and varies according to taxane sensitivity:
12.6 months in taxane-sensitive disease versus 8.9 months in taxane-resistant disease.
Patients with head and neck or pancreatic cancers did not experience improvements
in response rates or survival outcomes when treated with eribulin in clinical trials.
Eribulin is approved by the Food and Drug Administration for patients with previously
treated metastatic breast cancer and has demonstrated a survival benefit compared
with standard treatment options in this setting. Non–small cell lung cancer patients
had improved response rates when treated with eribulin in open-label, nonrandomized,
Phase II trials reported in abstract form. Eribulin was not effective in the treatment
of head and neck or pancreatic cancer in Phase II trials.