Eribulin (also known by its brand name Halaven) is a chemotherapy drug.
Before starting your treatment many hospitals will arrange a chemotherapy information session. At this appointment a nurse will discuss how and when your chemotherapy will be given and how side effects can be managed. Contact numbers will also be given so you know who to phone if you have any questions or concerns.
Find out more general information about chemotherapy.
You can also read our Chemotherapy for breast cancer booklet, which includes more information about how chemotherapy is given and side effects.
Who might be offered eribulin?
Eribulin is used to treat people with:
- secondary breast cancer – breast cancer that has spread from the breast to another part of the body
- locally advanced breast cancer (also known as regional recurrence) – breast cancer that has spread to the tissues and lymph nodes around the chest, neck and under the breastbone.
How does eribulin work?
Like other chemotherapy drugs, eribulin interferes with how cancer cells divide and grow.
How is it given?
Eribulin is given as a drip into a vein (intravenously) in the hand or arm, although there are other ways of giving it depending on factors such as how easy it is to find suitable veins. For further information read about the different ways chemotherapy may be given.
Eribulin is given over a number of sessions, called cycles. Each cycle lasts three weeks. You have your first dose of eribulin on day one of the cycle, and a second dose on day eight. Then you have a break with no treatment to give your body time to recover. The next cycle starts three weeks after the first dose.
Your specialist may want to see how well the treatment is working after the first two or three cycles. They might arrange a scan for you or they might ask if your symptoms are improving.
You’ll also have regular blood tests to check how you are and how well your liver and kidneys are working while you’re having eribulin. Any changes in liver and kidney function may not cause symptoms and usually return to normal after treatment has finished.
Eribulin is usually given for as long as it’s keeping the cancer under control, but this will vary for different people.
What are the side effects of eribulin?
Like any chemotherapy, eribulin can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. These can usually be controlled and those described here will not affect everyone. If you’re being given other anti-cancer drugs with eribulin you may also have side effects from those drugs.
If you’re concerned about any side effects, regardless of whether they are listed here, talk to your chemotherapy nurse or cancer specialist (oncologist) as soon as possible.
Side effects common to all chemotherapy drugs
Some side effects of eribulin are common to all chemotherapy drugs. These include:
- effects on the blood (such as risk of infection, anaemia, bruising and bleeding)
- hair thinning or loss (alopecia)
- nausea and vomiting
- sore mouth
- tiredness (fatigue)
- effects on fertility.
Find out more about the side effects common to all chemotherapy regimes.
Common side effects of eribulin
Numbness or tingling in hands or feet
Some people experience numbness or tingling in their hands or feet. This may make tasks such as doing up buttons difficult. This is due to the effect of eribulin on the nerves and is known as peripheral neuropathy. In most cases it’s mild. If it’s severe, it may be necessary to reduce the dose of eribulin or to stop it completely. These side effects normally improve slowly a few months after treatment has finished, but may not disappear completely.
If you are experiencing numbness or tingling, mention it to your specialist team when you see them next, so that the symptoms can be monitored.
Eribulin can cause changes to your heartbeat. Because of this you may have tests such as an ECG (electrocardiogram) to see if your heart is working normally before and during your treatment. If you develop symptoms such as palpitations (your heart feels like it's pounding, fluttering or beating irregularly) or chest pain, tell your specialist team.
You may have constipation. Drinking plenty of water and eating a high-fibre diet can help reduce constipation. Your specialist or GP can also prescribe something to help.
You may have diarrhoea. If you have four or more episodes of diarrhoea within 24 hours, let your doctor know. It’s important to drink plenty of fluids but your specialist or GP may also prescribe something to help.
Less common side effects of eribulin
- Some people develop soreness, redness and peeling of the palms of the hands and soles of the feet. This is known as Palmar-Plantar syndrome, which may cause tingling, numbness, pain and dryness. Keeping the feet and hands clean, dry and well moisturised can help. Sometimes people are prescribed vitamin B6 (pyridoxine) to help with these symptoms.
- Joint or muscle pain. Your specialist team may be able to suggest ways to help, such as taking anti-inflammatory pain relief.
- Reduced appetite. If it persists you can ask your specialist team or GP to refer you to a dietician.
- Shortness of breath and a cough. This is usually mild but tell your specialist team if you develop wheezing or a temperature or if any existing breathing problems get worse.
- Eye problems including blurred vision, sore, itchy, dry eyes, or infection. Your specialist team may prescribe eye drops to help relieve these symptoms.
- Low levels of potassium in your blood. You’ll have regular blood tests to check the levels of potassium.
If you experience any of these side effects, contact your specialist team as they will be able to advise you on how best to manage them.