Eribulin Mesylate Injection: Uses, Dosage, Side Effects & Clinical Benefits

Patients with advanced cancers who have already received multiple treatment regimens now have new treatment possibilities through Eribulin drug therapy. The diagnosis of metastatic breast cancer or unresectable/metastatic liposarcoma leads patients to experience uncertainty about their treatment options. Eribulin mesylate injection was developed as a synthetic analogue of halichondrin B, a compound originally isolated from marine sponges.

This therapy represents a meaningful advancement in oncology. Specifically designed for patients whose cancer has progressed despite standard treatments, the eribulin drug helps shift the focus from solely attempting a cure to extending life while preserving quality of life. The drug eribulin mesylate injection contains 0.44 mg/mL eribulin base, which equals 0.5 mg/mL eribulin mesylate salt. The compound functions as a complete synthetic form of halichondrin B, which maintains the anti-cancer effects of its natural form while avoiding the difficulties involved in obtaining the marine sponge material. The drug design targets cancer cell growth interruption, which provides treatment options for patients who do not respond to standard medical approaches.

What Is Eribulin Mesylate Injection (Halaven) and How Does It Work?

At its core, eribulin mesylate injection is a non-taxane microtubule dynamics inhibitor. Imagine a cancer cell as a construction site. For the cell to divide, it must assemble internal scaffolding made of microtubules. Many traditional chemotherapy agents either destroy that scaffolding or prevent it from forming at all.

The Eribulin drug works differently. It binds specifically to the growing “plus ends” of microtubules. Instead of dismantling them completely, it freezes them mid-growth. The cell becomes stuck during division. Unable to complete mitosis, it undergoes programmed cell death. This mechanism is important. Because it does not stabilize microtubules like taxanes, it may partially bypass resistance seen in taxane-pretreated tumors. Preclinical studies summarized by the National Cancer Institute (Breast Cancer Treatment Guidelines) suggest eribulin may also influence tumor biology beyond cytotoxicity, possibly reversing epithelial-to-mesenchymal transition (EMT), a process associated with metastasis (the spread of cancer to other parts of the body).

Eribulin Mesylate Injection Uses for Breast Cancer & Liposarcoma Treatment

Regulatory approvals define where this therapy fits. The U.S. Food and Drug Administration (HALAVEN Prescribing Information) approved the eribulin drug in 2010 for metastatic breast cancer after at least two prior chemotherapy regimens. The European Medicines Agency (HALAVEN EPAR) followed in 2011. Today, approved eribulin mesylate injection uses include:

• Metastatic breast cancer after prior anthracycline and taxane therapy.

• Unresectable or metastatic liposarcoma after anthracycline-containing regimens.

In the UK, access is guided by the National Institute for Health and Care Excellence (NICE), which has recommended its use in defined late-line settings under NHS criteria. It is not indicated as first-line therapy. Trials in earlier-line HER2-negative disease did not show superiority over capecitabine (Study 301, Kaufman PA et al., Journal of Clinical Oncology, 2015).

Eribulin Drug Survival Data: Key Results from the EMBRACE Clinical Trial

The pivotal EMBRACE trial, published in The Lancet (Cortes et al., 2011), compared eribulin mesylate injection with treatment of the physician’s choice in heavily pretreated patients (those who have already tried many other types of chemotherapy) for metastatic breast cancer. Results showed:

• Median overall survival: 13.1 months (Eribulin drug) vs 10.6 months (control).

• Hazard ratio: 0.81 (95% CI [0.66, 0.99]).

• Progression-free survival: Not significantly different.

This “tail-of-the-curve” effect suggests biologic modulation beyond immediate tumor shrinkage. In liposarcoma, a phase III trial published in The Lancet (Schöffski et al., 2016) demonstrated improved overall survival versus dacarbazine. In late-stage disease, incremental survival gains matter practically.

You can also check out: Cabozantinib Tablets: Uses, Dosage, Side Effects, and Complete Buying Guide

Eribulin Drug Dosing Guide: Pharmacokinetics and IV Administration Protocols

Standard dosing of eribulin mesylate injection:

• Standard dosing of eribulin mesylate injection is 1.4 mg/m² (as eribulin mesylate) in the USA/Canada, which is equivalent to 1.23 mg/m² (as eribulin base) used in the UK/EU.

• The 1.23 mg/m² (base) expression is the standard clinical label and regulatory dose in the UK, European Union, and several other regions.

• Given IV over 2–5 minutes on Day 1 and Day 8 of a 21-day cycle.

The study (Goel S et al., Cancer Chemotherapy and Pharmacology, 2015) showed triphasic elimination supports intermittent dosing without significant accumulation. Dose reductions (to 1.1 mg/m² (as eribulin mesylate) and then to 0.7 mg/m² in the US; or 0.97 mg/m² and 0.62 mg/m² in the UK/EU) are recommended for severe neutropenia (a drop in infection-fighting white blood cells) or moderate hepatic impairment (Child-Pugh B).

Eribulin Side Effects:  Patient Safety & Toxicity Mitigation  

No chemotherapy is without risk. The Eribulin drug has a predictable hematologic profile.

• Common eribulin side effects: Neutropenia (45–52% Grade 3–4), fatigue, hair loss, nausea, constipation, and peripheral neuropathy (nerve damage causing tingling or numbness in hands/feet; approximately 35% any grade).

• Serious Eribulin Side Effects (Seek Medical Help): Febrile neutropenia (fever ≥38°C), severe infection, QT interval prolongation, and hypersensitivity reactions.

Eribulin side effects like neutropenia are dose-dependent. CBC monitoring before each dose is mandatory. Authoritative patient guidance from Cancer Research UK and Mayo Clinic emphasizes early reporting to allow dose adjustment.

Who Should Not Take the Eribulin Drug?

• Contraindications: in patients with known hypersensitivity to eribulin. Use in pregnancy is not recommended due to fetal risk. QT prolongation is a warning/precaution rather than a formal contraindication per most labeling.

• Drug Interactions: Caution with QT-prolonging agents and other myelosuppressive drugs. Eribulin is minimally metabolized by CYP3A4; strong CYP3A4 modulators are not considered clinically significant interactions per labeling.

Stability, Storage & Global Supply Chain Of Eribulin Mesylate Injection

In B2B pharmacy wholesale distributors settings, maintaining validated storage is essential. Companies such as Oddway International participate in business-to-business oncology distribution across the USA, Canada, Germany, Italy, Taiwan, and Indonesia. Halaven should be stored at 25°C (77°F); excursions permitted to 15°–30°C (59°–86°F). Do not freeze or refrigerate.

Eribulin Mesylate Injection Price and Access in the UK

The eribulin mesylate injection price varies globally. The United Kingdom uses NICE cost-effectiveness thresholds to determine its pricing structure. The final eribulin mesylate injection price in the USA, Canada, Germany, Italy, Taiwan, and Indonesia is determined by local regulatory procedures and Wholesale pharmacy profit margins. The determination of clinical indications must take priority over cost considerations.

 Sequencing decisions are driven primarily by patient eligibility and survival data.

The Eribulin drug provides a statistically proven overall survival benefit for those who have exhausted standard paths. In oncology, meaningful victories are measured in time reached and quality of life preserved.

References

• Cortes J et al. EMBRACE Trial. The Lancet. 2011.

• Kaufman PA et al. Study 301. Journal of Clinical Oncology. 2015.

• FDA. HALAVEN (eribulin mesylate injection) Prescribing Information.

• European Medicines Agency. HALAVEN EPAR.

• National Cancer Institute. Breast Cancer Treatment Guidelines.

• Goel S et al. Clinical Pharmacokinetics of Eribulin. Cancer Chemotherapy and Pharmacology. 2015.

• Schöffski P et al. Eribulin versus dacarbazine in advanced liposarcoma (SAR-3007). The Lancet. 2016

Frequently Asked Questions

Q: What are the primary side effects of Eribulin, and is hair loss permanent?

A: The most common serious side effects are neutropenia (low white blood cells), anemia, and fatigue. Approximately 35% of patients experience peripheral neuropathy, which becomes reversible through dose adjustments. About 45% of patients experience hair loss, which temporarily lasts until 3 to 6 months after treatment ends when regrowth starts.

Q: How effective is Eribulin for treating liposarcoma?

A: It is indicated for unresectable or metastatic liposarcoma after prior anthracycline therapy. Phase III trials show improved overall survival: 15.6 months versus 8.4 months with dacarbazine.

Q: What is the standard dosing schedule for eribulin?

A: 1.4 mg/m² IV on Days 1 and 8 of a 21-day cycle. The schedule allows bone marrow recovery, targeting the white blood cell nadir. Dose adjustments are needed for hepatic impairment: mild (1.1 mg/m²), moderate (0.7 mg/m²), severe (not recommended).

Q: Can eribulin be used in patients with peripheral neuropathy?

A: Yes, with close monitoring. Grade 3–4 neuropathy requires withholding the drug until it improves to ≤ Grade 2.

Q: How is eribulin different from other microtubule inhibitors?

A: Eribulin selectively inhibits the mitotic spindle to induce apoptosis with less neurotoxicity than vinca alkaloids or taxanes. Unlike taxanes, routine steroid or antihistamine pre-medication is not needed.