HALAVEN® was studied in patients with advanced liposarcoma or leiomyosarcoma and with intermediate-to-high tumor grades1

Liposarcoma stratum

    BASELINE PATIENT CHARACTERISTICS2
    SELECTED PATIENT FACTORS
    LIPOSARCOMA STRATUM
    (n=143)
    Median age 55 years
    Sex Female 38%
    ECOG PS 0 41%
    1 53%
    Prior systemic chemotherapies >2 44%
    Liposarcoma histological subtype Dedifferentiated 45%
    Myxoid/round cell 37%
    Pleomorphic 18%

    All patients


    BASELINE PATIENT CHARACTERISTICS1,3
    SELECTED PATIENT FACTORS
    HALAVEN
    (n=228)
    DACARBAZINE
    (n=224)
    Age <65 years 78%

    79%

    ≥65 years 22% 21%
    Sex Female 71% 63%
    ECOG PS 0 49% 40%
    1 50% 54%
    2 1% 6%
    Histology Liposarcoma 33% 35%
    Leiomyosarcoma 67% 65%
    Liposarcoma histological subtype Dedifferentiated 14% 17%
    Myxoid/round cell 13% 12%
    Pleomorphic 6% 7%
    Leiomyosarcoma primary site Uterine 3% 28%
    Nonuterine 36% 37%
    Unknown <1% 0%
    Tumor grade High 66% 68%
    Intermediate 34% 31%
    Not known <1% 1%
    Number of prior regimens for advanced disease 1 7% 6%
    2 51% 44%
    >2 42% 50%

    ECOG PS=Eastern Cooperative Oncology Group performance status.


    *Subject to patient eligibility.

    Indications

    Metastatic Breast Cancer

    HALAVEN (eribulin mesylate) Injection is indicated for the treatment of patients with metastatic breast cancer (mBC) who have previously received at least 2 chemotherapeutic regimens for the treatment of metastatic disease. Prior therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting.

    Liposarcoma

    HALAVEN is indicated for the treatment of patients with unresectable or metastatic liposarcoma who have received a prior anthracycline-containing regimen.

    Important Safety Information

    Warnings and Precautions

    Neutropenia: Severe neutropenia (ANC <500/mm3) lasting >1 week occurred in 12% of patients with mBC and liposarcoma or leiomyosarcoma. Febrile neutropenia occurred in 5% of patients with mBC and 2 patients (0.4%) died from complications. Febrile neutropenia occurred in 0.9% of patients with liposarcoma or leiomyosarcoma, and fatal neutropenic sepsis occurred in 0.9% of patients. Patients with mBC with elevated liver enzymes >3 × ULN and bilirubin >1.5 × ULN experienced a higher incidence of Grade 4 neutropenia and febrile neutropenia than patients with normal levels. Monitor complete blood cell counts prior to each dose, and increase the frequency of monitoring in patients who develop Grade 3 or 4 cytopenias. Delay administration and reduce subsequent doses in patients who experience febrile neutropenia or Grade 4 neutropenia lasting >7 days.

    Peripheral Neuropathy: Grade 3 peripheral neuropathy occurred in 8% of patients with mBC (Grade 4=0.4%) and 22% developed a new or worsening neuropathy that had not recovered within a median follow-up duration of 269 days (range 25-662 days). Neuropathy lasting >1 year occurred in 5% of patients with mBC. Grade 3 peripheral neuropathy occurred in 3.1% of patients with liposarcoma and leiomyosarcoma receiving HALAVEN and neuropathy lasting more than 60 days occurred in 58% (38/65) of patients who had neuropathy at the last treatment visit. Patients should be monitored for signs of peripheral motor and sensory neuropathy. Withhold HALAVEN in patients who experience Grade 3 or 4 peripheral neuropathy until resolution to Grade 2 or less.

    Embryo-Fetal Toxicity: HALAVEN can cause fetal harm when administered to a pregnant woman. Advise females of reproductive potential to use effective contraception during treatment with HALAVEN and for at least 2 weeks following the final dose. Advise males with female partners of reproductive potential to use effective contraception during treatment with HALAVEN and for 3.5 months following the final dose.

    QT Prolongation: Monitor for prolonged QT intervals in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, and electrolyte abnormalities. Correct hypokalemia or hypomagnesemia prior to initiating HALAVEN and monitor these electrolytes periodically during therapy. Avoid in patients with congenital long QT syndrome.

    Adverse Reactions

    In patients with mBC receiving HALAVEN, the most common adverse reactions (≥25%) were neutropenia (82%), anemia (58%), asthenia/fatigue (54%), alopecia (45%), peripheral neuropathy (35%), nausea (35%), and constipation (25%). Febrile neutropenia (4%) and neutropenia (2%) were the most common serious adverse reactions. The most common adverse reaction resulting in discontinuation was peripheral neuropathy (5%).

    In patients with liposarcoma and leiomyosarcoma receiving HALAVEN, the most common adverse reactions (≥25%) reported in patients receiving HALAVEN were fatigue (62%), nausea (41%), alopecia (35%), constipation (32%), peripheral neuropathy (29%), abdominal pain (29%), and pyrexia (28%). The most common (≥5%) Grade 3-4 laboratory abnormalities reported in patients receiving HALAVEN were neutropenia (32%), hypokalemia (5.4%), and hypocalcemia (5%). Neutropenia (4.9%) and pyrexia (4.5%) were the most common serious adverse reactions. The most common adverse reactions resulting in discontinuation were fatigue and thrombocytopenia (0.9% each).

    Use in Specific Populations

    Lactation: Because of the potential for serious adverse reactions in breastfed infants from eribulin mesylate, advise women not to breastfeed during treatment with HALAVEN and for 2 weeks after the final dose.

    Hepatic and Renal Impairment: A reduction in starting dose is recommended for patients with mild or moderate hepatic impairment and/or moderate or severe renal impairment.

     

    References: 1. Schöffski P, Chawla S, Maki RG, et al. Eribulin versus dacarbazine in previously treated patients with advanced liposarcoma or leiomyosarcoma: a randomised, open-label, multicentre, phase 3 trial. Lancet. 2016;387(10028):1629-1637. 2. HALAVEN [package insert]. Woodcliff Lake, NJ: Eisai Inc; 2016. 3. Data on file, Eisai, Inc.