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Eribulin (Halaven)

A microtubule inhibitor indicated for the treatment of metastatic breast cancer in patients who have previously received at least two chemotherapy regimens.

A nontaxane microtubular dynamics inhibitor.

An analog of halichondrin B, a compound found naturally in marine sponges.

Inhibits the growth phase of microtubules without affecting the shortening phase and sequences tubulin into nonproductive aggregates.

Creates an irreversible mitotic blockade, leading to loss of long-term cell viability.

Suppresses microtubule growth and sequesters tubulin into nonfunctional aggregates without affecting microtubular depolymerization.

Binds to a different site on the microtubules than taxanes or the vinca alkaloids.

Leads to G2/M cell-cycle block, disrupts mitotic spindles, and ultimately leads to a proptosis after prolonged mitotic blockage.

Approved for the treatment of patients with metastatic breast cancer who have received at least 2 chemotherapeutic regimens for the treatment of metastatic disease, and whose prior therapy included an anthracycline and a taxane in either an adjuvant or metastatic setting.

Erbulin has demonstrated improved survival in patients who received at least 2 prior chemotherapy treatments, including TNBCs.

Half-life approximately 40 hours.

No accumulation with weekly administration.

Prior treatment should include an anthracycline and a taxane in the adjuvant or metastatic setting.

Approved for the treatment of patients with inoperable soft tissue sarcoma (leiomyosarcoma and liposarcoma) were received prior chemotherapy for advanced or metastatic disease.

In a phase III study EMBRACE study comparing this agent with the physicians choice in patients with progressive metastatic breast cancer and found they had a median overall survival of 13.1 months compared to 10.7 months.

The combination of pembrolizumab and eribulen in the ENHANCE/Keynote-150 study demonstrated a 26.45 response rate in metastatic TNBC.

Improves overall survival in patients with advanced leiomyosarcoma and liposarcoma.

Dosage should be reduced in patients with hepatic impairment and moderate renal impairment.

Most adverse reactions within incidence of 25% or greater include: Neutropenia, anemia, asthenia, fatigue, alopecia, peripheral neuropathy, nausea, and constipation.

Prolongs QT interval an EKG monitor is recommended in patients with congestive heart failure, bradycardia arrhythmias, and drugs known to prolong the QT interval, and electrolyte abnormalities.

Treatment is 1.4 mg meter squared IV over 2-5 minutes on days one and 8 of a 21 day cycle.

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