The product information for Halaven® (eribulin) has been updated to include a new indication. In addition to the treatment of locally advanced or metastatic breast cancer, eribulin is now also approved for the treatment of unresectable liposarcoma in patients who have previously received chemotherapy for advanced or metastatic disease.

Eribulin is a synthetic analogue of halichondrin B, a natural agent isolated from a Japanese marine sponge. This microtubule dynamics inhibitor causes prolonged and irreversible mitotic blockade that results in apoptosis. Unlike vinca alkaloids and taxanes, eribulin inhibits the growth phase of microtubules without affecting the shortening phase. This distinct mechanism of action may make eribulin a valuable option for refractory disease.

The efficacy of eribulin in liposarcoma is supported by the results of a pivotal Phase 3 trial undertaken in patients with liposarcoma or leiomyosarcoma. Median overall survival was two months higher in patients treated with eribulin compared to dacarbazine, although survival benefit appeared to be limited to patients with liposarcoma. Subgroup analysis of these patients demonstrates a mean overall survival of 15.6 months for eribulin and 8.4 months for dacarbazine. However, the study was not sufficiently powered to evaluate survival differences between treatment arms in this subgroup.

Eribulin is currently only subsidised on the Pharmaceutical Benefits Scheme (PBS) for the treatment of breast cancer. However, the Pharmaceutical Benefits Advisory Committee (PBAC) made a positive recommendation for PBS listing for liposarcoma in November 2016.

References:

  1. Doherty MK, Morris PG. Eribulin for the treatment of metastatic breast cancer: an update on its safety and efficacy. Int J Womens Health. 2015; 7: 47-58.
  2. Halaven (eribulin) Australian approved product information. Melbourne: Eisai Australia Pty Ltd. Approved November 2016.
  3. Pharmaceutical Benefits Advisory Committee. Eribulin: Public summary document – November 2016 PBAC meeting. Canberra: Pharmaceutical Benefits Scheme; 2017.

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