Drug reference
Treatment of locally advanced or metastatic breast cancer when the disease has progressed after treatment with at least 1 chemotherapy regimen for advanced disease ▶BY INTRAVENOUS INJECTION ▶Adult: Give on day 1 and day 8 of a 21-day cycle, previous therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting unless the patient is unsuitable for these treatments (consult local protocol)
PDF page 1006
Congenital long QT syndrome
PDF page 1006
Bradyarrhythmias (increased susceptibility to QT-interval prolongation). congestive heart failure (increased susceptibility to QT-interval prolongation). electrolyte disturbances (increased susceptibility to QT- interval prolongation). susceptibility to QT-interval prolongation
PDF page 1007
NICE decisions ▶Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens (December 2016) NICE TA423 Eribulin (Halaven ®) is recommended for the treatment of locally advanced or metastatic breast cancer, only if: . the condition has progressed after at least 2 chemotherapy regimens (which may include an anthracycline or a taxane, and capecitabine), and . the manufacturer provides eribulin with the discount agreed in the patient access scheme. Patients whose treatment was started within the NHS before this guidance was published should continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta423 ▶Eribulin for treating locally advanced or metastatic breast cancer after 1 chemotherapy regimen (March 2018) NICE TA515 Eribulin (Halaven ®) is not recommended for treating locally advanced or metastatic breast cancer in adults who have had only 1 chemotherapy regimen. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta515 Immune system and malignant disease Scottish Medicines Consortium (SMC) decisions SMC No. 1065/15 The Scottish Medicines Consortium has advised (March 2016) that eribulin (Halaven ®) is accepted for restricted use within NHS Scotland for the treatment of patients with locally advanced or metastatic breast cancer that has progressed after at least two prior chemotherapy regimens for advanced disease, which includes capecitabine if indicated. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
PDF page 1007
→Appendix 1: eribulin
PDF page 1007
▶Common or very common Alopecia. anaemia. appetite decreased. arthralgia. asthenia. chest pain. chills. conjunctivitis. constipation. cough. decreased leucocytes . dehydration. depression. diarrhoea. dizziness. dry mouth. dyspnoea. dysuria. electrolyte imbalance. embolism and thrombosis. excessive tearing. fever. gastrointestinal discomfort. gastrooesophageal reflux disease. haemorrhage. headache. hot flush. hyperbilirubinaemia. hyperglycaemia. increased risk of infection. influenza like illness. insomnia. lethargy. mucositis. muscle complaints. muscle weakness. nail disorder. nausea. nerve disorders. neurotoxicity. neutropenia. oral disorders. oropharyngeal pain. pain. peripheral oedema. rhinorrhoea. sensation abnormal. skin reactions. sweat changes. tachycardia. taste altered. thrombocytopenia. tinnitus. vertigo. vomiting. weight decreased ▶Uncommon Angioedema. hepatotoxicity. interstitial lung disease. pancreatitis. proteinuria. renal failure. sepsis ▶Rare or very rare Disseminated intravascular coagulation ▶Frequency not known QT interval prolongation. severe cutaneous adverse reactions (SCARs)
PDF page 1007
Ensure effective contraception during and for up to 3 months after treatment in men or women.
PDF page 1007
Avoid unless essential (teratogenic in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
PDF page 1007
Discontinue breast-feeding.
PDF page 1007
Manufacturer advises caution (increased risk of neutropenia). Dose adjustments Manufacturer advises dose reduction— consult product literature.
PDF page 1007
Dose adjustments Consider dose reduction if creatinine clearance less than 40 mL/minute.
PDF page 1007
▶Monitor for signs of peripheral neuropathy—severe peripheral neurotoxicity requires treatment delay or dose reduction (consult product literature). ▶ECG monitoring recommended in patients prescribed concomitant use of drugs that prolong the QT-interval or who are susceptible to QT-interval prolongation. ▶Monitor electrolytes periodically.
PDF page 1007
There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Ethanol ▶Halaven (Eisai Ltd) Eribulin.44 mg per 1 ml Halaven 0.88mg/2ml solution for injection vials | 1 vial P £361.00 (Hospital only)
PDF page 1007
Give on day 1 and day 8 of a 21-day cycle,
First-line fragment. Read the complete Indications and Dose section above.
PDF page 1006
