Eribulin Is Well Tolerated in Metastatic Breast Cancer

M. Alexander Otto, MMS, PA

February 17, 2022

The study covered in this summary was published on as a preprint and has not yet been peer reviewed.

Key Takeaways

  • In a postmarketing study, eribulin (Halaven) was well tolerated by patients with metastatic breast cancer, with few women discontinuing because of adverse events.

  • However, two single-nucleotide polymorphisms (SNPs) were associated with severe peripheral neuropathy.

Why This Matters

  • As a newer chemotherapy option, real-world safety data are needed to guide the use of eribulin for breast cancer.

  • The genetic findings, if confirmed, could identify women who should not be taking the drug.

Study Design

  • The phase 4 review included 180 women; the median age was 60 years.

  • The majority (65%) had luminal B HER2-negative disease.

  • Overall, the women had received a median of five lines of prior treatment, including taxanes (in 97%).

  • The median number of eribulin cycles was 4.5 but ranged from 1 to 23.

Key Results

  • Over a median follow-up of 15.4 months, median overall survival was 12 months, which aligns with findings from previous reports.

  • Sixty-five patients (38.2%) had at least one severe adverse event.

  • Neutropenia (15.3%) and neurotoxicity (14.7%) were the most common adverse events.

  • Other toxicities included bone/muscle, abdominal, or tumor site pain (19.4%) as well as liver injury (6.6%) and pulmonary (6.5%) and dermatologic (3.6%) adverse events.

  • Most events happened within the first six treatment cycles.

  • Doses were reduced for almost half of women, mainly because of neutropenia (23.9%) and liver injury (12%), but only 3.5% discontinued treatment because of adverse events.

  • Surveys after three cycles found that social, physical, and emotional quality of life were intact but progressively worsened toward the end of treatment.

  • Among 15 evaluated SNPs, two polymorphisms — rs2233335 (T/T) in the NDRG1 gene and rs7214723 (T/T) in the CAMKK1 gene — were associated with severe peripheral neurotoxicity.


  • No study limitations were reported.


  • The work was funded by Eisai, the maker of eribulin.

  • Several investigators reported ties to Eisai and other companies.

This is a summary of a preprint research study, "Tolerability of Eribulin and Correlation Between Polymorphisms and Neuropathy in an Unselected Population of Female Patients with Metastatic Breast Cancer: Results of The Multicenter, Single Arm, Phase IV PAINTER Study," led by Nicla La Verde of Luigi Sacco Hospital, Milan. The study has not been peer reviewed. The full text can be found at

M. Alexander Otto is a physician assistant with a master's degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email:

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.