eribulin

Eribulin mesylate is a chemotherapy agent marketed under the brand name Halaven and used to treat certain cancers. It is a synthetic analog of halichondrin B, a natural product originally isolated from the marine sponge Halichondria okadai. Eribulin acts as a microtubule dynamics inhibitor, binding to the ends of microtubules and preventing their growth. This disrupts mitotic spindle formation, leading to mitotic arrest and cancer cell death. Its mechanism is distinct from other microtubule-targeting drugs such as taxanes and vinca alkaloids.

In the United States, eribulin is approved for treatment of adults with metastatic breast cancer that has progressed after at least two prior chemotherapy regimens for metastatic disease. In 2016, the U.S. Food and Drug Administration also approved eribulin for unresectable or metastatic liposarcoma after prior anthracycline-containing therapy. The European Medicines Agency has similarly authorized eribulin for liposarcoma, and it is used in other jurisdictions under comparable indications.

Administration is by intravenous infusion, typically on days 1 and 8 of a 21-day cycle. The usual dose is 1.4 mg per square meter of body surface area per dose, given over a short infusion. Treatment cycles continue until disease progression or intolerable toxicity, with dose modifications as needed for safety.

Common adverse effects include neutropenia, fatigue, alopecia, peripheral neuropathy, nausea, vomiting, constipation, and decreased appetite. Other risks can include febrile neutropenia, electrolyte abnormalities, and QT interval prolongation. Eribulin is contraindicated in pregnancy and requires appropriate monitoring and supportive care to manage potential hematologic and non-hematologic toxicities. The drug is generally given to patients who have exhausted other chemotherapy options or for whom established regimens exist.