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Eribulin (Halaven) experiences?

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btstark2003 View Drop Down
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    Posted: Mar 25 2015 at 8:50am
Hi all,

I am considering starting on eribulin.  My oncologist at MGH says that most of his TNBC patients respond to it for a while, some have remained stable on eribulin for 8-12 months.  He says it is reasonably well tolerated, with hair loss, nausea and some fatigue being the most common side effects.  He says that suppression of white cells (which really concerns me and I have been sick to due to leukopenia/neutropenia before) is usually not much of an issue.

I would really appreciate if anyone who has been on this drug would share how it worked for them and how they tolerated it!

Thanks,
Beth
2008 Stg1 TNBC, LX, FEC+T, rads
2010 2.5cm tumor BRCA-, BMX,CMF
2011 LN mets, Gem/Carbo, surgery, rads
2012 lung mets, PI3Ki/taxo
2013 anti-PD-1
2014/15 Xeloda, IMMU-132, eribulin
Aug 2015 Keytruda
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Linda428 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Linda428 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 25 2015 at 12:55pm
Beth,
I am very sensitive to chemo but Eribuilin wasn't too bad. I lost my hair, had nausea for about three days and had low cell counts but not as bad as with other chemo's. I did four months of Eribuilin but ended up with a mixed response---as I have on ALL chemo's. I think you will still be able to function ok----fatigue wasn't really a problem for me. I wish you luck in making your decisions! My prayers are with you!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote btstark2003 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 28 2015 at 2:12pm
Linda,

Thanks for this and all the other advice and support that you have provided.  I am praying often for your healing.  I have the first eribulin infusion scheduled for April 6, but I don't know for sure yet if I will do it.  Praying for guidance!  I am grateful that I have lots of time this weekend to devote to my health - walking, yoga, Xigong, meditation, juicing, healing prayers etc.  I hope that you are feeling well enough to do the things that you love and that will heal you.

Beth
2008 Stg1 TNBC, LX, FEC+T, rads
2010 2.5cm tumor BRCA-, BMX,CMF
2011 LN mets, Gem/Carbo, surgery, rads
2012 lung mets, PI3Ki/taxo
2013 anti-PD-1
2014/15 Xeloda, IMMU-132, eribulin
Aug 2015 Keytruda
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Tonya98 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tonya98 Quote  Post ReplyReply Direct Link To This Post Posted: Apr 02 2015 at 10:48am
Praying for your decision process and for healing.
 
Tonya
2/1/07 -IDC 2.5cm node positive her2+ ACT&herceptin.

1/8/08 recurrence to skin -triple negative. 07/23/10 -chest wall. Parp trial 9/10 - present. Iniparib ending November 2015 Stable 9/19/2016
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2015 at 9:22pm
Beth,

I just saw this article about an Eribulin clinical trial:

Corcept Therapeutics' Mifepristone Combined With Eribulin to Improve Antitumor Activity in Patients With Triple-Negative Breast Cancer

DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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btstark2003 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote btstark2003 Quote  Post ReplyReply Direct Link To This Post Posted: May 16 2015 at 9:49am
Dear Friends,

Thanks for sharing that trial info, Donna.  I will keep an eye on it.  The PI quoted in the article, Rita Nanda, was my oncologist when I was on the the anti-PD-1 immunotherapy trial at Univ of Chicago Medicine.

I am happy to report that I am tolerating eribulin  well after 5 weeks and 3 doses (once every 2 weeks)  My hair, eyebrows, and eyelashes are even growing back!  It turns out that not everyone has hair loss on eribulin.  And after an initial plunge in my RBC count and hemoglobin, they have gone back up and I am less anemic now that I have been in a long time.  I am still coughing from the lung mets, but it might be a little less severe.  And I have some fatigue, and can't do any strenuous exercise, but it's manageable.  I am still working full time and gardening :) And it's a heck of a lot easier to pop over to the Siteman Cancer Center for a treatment that takes less than 1.5 hours once my lab results arrive than to fly to Boston and back twice in every 3 week period!  I feel like I have a fairly normal life again.

So praying that this keeps me stable for a long while!

Beth
2008 Stg1 TNBC, LX, FEC+T, rads
2010 2.5cm tumor BRCA-, BMX,CMF
2011 LN mets, Gem/Carbo, surgery, rads
2012 lung mets, PI3Ki/taxo
2013 anti-PD-1
2014/15 Xeloda, IMMU-132, eribulin
Aug 2015 Keytruda
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megarita View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote megarita Quote  Post ReplyReply Direct Link To This Post Posted: May 26 2015 at 7:52pm
Beth, so glad to hear the eribulin is working, please keep us posted on it, my Mom has stage IV (a reoccurrence after 10 years) mets to liver and sternum and started with on Xeloda and now on the pI3k and taxol trial but it's not working so her next options are the immu132 or Eribulin. Would love any input you could give between the two therapies. Did the immu-132 have no positive result for you?

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Post Options Post Options   Thanks (0) Thanks(0)   Quote btstark2003 Quote  Post ReplyReply Direct Link To This Post Posted: May 28 2015 at 9:04pm
Hi Megarita,
 
The IMMU-132 kept me stable for about 4 months, but caused hair loss and white blood cell suppression, anemia and GI side effects and during the fifth month I had progression of the lung mets and got really sick due to WBC count crashing.   So I don't really think it's any more promising than eribulin, so if I had it to do over again I would choose eribulin first because it probaly has just as good a chance of helping for a while as IMMU-132, but is less toxic.
 
Has your Mom been offered any trials of anti-PD1 (such as Keytruda) or anti-PD-L1 antibodies?  THis is immunotherapy and for me it had no side effects at all and it controlled my lung mets  for 5 months (the largest one kept growing for 3 months and then stabilized) and was really still controlling it but I had a 0.1cm increase in the largest met at the 5-month CT scan and they kicked me off the trial.  Even though I was VERY healthy and completely asymptomatic - it was devastating.  Then I had Xeloda after that, which didn't help for long at all and I hated the side effects, and then IMMU-132. 
 
I think immunotherapy approaches are the best hope we have.  Every chemotherapy agent, including IMMU-132 which is an antibody-drug conjugate that is targeted (but the targeting is not great as evidenced by the side effects) does damage to normal cells along with the cancer cells.  If eribulin turns out not to be shrinking my cancer cells, I will probably not do any further chemotherapy, but would consider another immunotherapy trial if I could find one that would let me in.  An anti-PD1 by itself would probably not help me much now because my tumors are too big.  It works better on smaller mets (in my case it worked better on the ones that were less than 2.5cm)  Don't get me wrong, I would not be giving up!  I would just focus only on alternative/complementary approaches and I also plan to go to an Integrative Oncology center for advice on a tailored regimen of supplements etc soon.
 
It is VERY rare to have a recurrence of TNBC after 10 years.  So your mom was doing something right during those ten years.  Did something change during the year or two before the recurrence? Such as changes in diet, supplementsexercise, immune system suppression, stress level?   Any one of these could have changed the environment in the body to allow the cancer to grow again.  If she can think of something ,maybe she should try to change it back to whatever she was doing during the long disease-free interval. 
 
I highly recommend the book Radical Remission.  It would give you and your mom ideas on other things to try in addition to or instead of chemotherapy.  It has stories of many people who have overcome metastatic cancers of all types, and is very inspirational!
 
Peace to you and your mother,
Beth
2008 Stg1 TNBC, LX, FEC+T, rads
2010 2.5cm tumor BRCA-, BMX,CMF
2011 LN mets, Gem/Carbo, surgery, rads
2012 lung mets, PI3Ki/taxo
2013 anti-PD-1
2014/15 Xeloda, IMMU-132, eribulin
Aug 2015 Keytruda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tnbcbrother Quote  Post ReplyReply Direct Link To This Post Posted: May 31 2015 at 9:47pm
Hi all,

My sister, a tnbc patient with ultiple mets has recently developed mets in brain also.

She has tried several chemos without any respite since Mar 2014. After foundation one report, she has taken 13 doses (10 mg each) of Affinator, after which she had serious side effects including consolidation of lungs.

Her oncologist suggest radio therapy for brain mets, with no guarantee that brain tumuors would not come again. For the overall disease treatment he suggest erinulin may be tried but it may have more severe side effects.

I got to know about IMMU-132, but it is available in U.S. Only and we are in India now. I am not sure that given her lungs consolidation problem, she would be able to travel or not. I am also not sure if radiation to brain should be given or not. How would eribulin react, not sure.

Please share your thoughts on this, would really be helpful.

Many thanks.

Kindest Regards
Vibhor Singhal
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megarita View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote megarita Quote  Post ReplyReply Direct Link To This Post Posted: Jun 15 2015 at 8:47pm
Beth, Thanks for your advice, she asked about the anti-PD1 (such as Keytruda) or anti-PD-L1 antibodies and she has to be positive for some marker to qualify but her oncologist is checking to see if she will qualify. In the meantime she has stopped taxol since it was not helping and she'll need to be off meds for 4 weeks to begin the immu trial (if she qualifies). Her Dr wants her to start with the immu trial 1st then use eribulin as a back up because she does not have to qualify to use eribulin.  

To answer your question about the 10 year occurrence. She worked full time through the 1st diagnosis 10 years back and she had a stressful job at the time. She retired a couple years ago and has been traveling and enjoying herself. This is a woman who goes (went) to the gym 3-4x a week, works in her garden all the time, goes biking, walking etc...very physically fit.  Eats very healthy, lots of veggies, there is nothing that we could pinpoint to "cause" a reoccurrence.  I think we all thought she was out of the woods after 5 years.... 

The hardest part about the reoccurrence has been the plueral effusion, she's having to get a lung tap every week now and breathing is difficult so she can no longer be as active as she'd like. We had hoped the chemo would have alleviated that symptom, so maybe the next one will. 

I hope your still feeling good and the eribulin is helping!

Best,
Megan

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Post Options Post Options   Thanks (0) Thanks(0)   Quote btstark2003 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 20 2015 at 4:11pm
Hi Megan,

It's likely that her oncologist is having her tumor sample checked for expression of PD-L1 - a number of the anti-PD1 trials are now requiring confirmation of this marker.  It's probably a good thing because some of the clinical study results in metastatic melanoma have shown that patients who don't have PD-L1 expression do not respond to the drug.

So perplexing that she had been living such a healthy lifestyle and had a recurrence after years in remission.  I am sorry to hear about the pleural effusion.  I hope that the next drug relieves it.

I am sorry to say that eribulin did not work for me, but I know that it does for plenty of people!  My tumors are not growing fast and my only symptom from the lung mets is coughing.

My next step is to go for a consultation at the Block Center for Integrative Cancer Care in the Chicago area next week.  I am excited to hear about their recommendations for me!

Peace and healing thoughts for your mother,
Beth
2008 Stg1 TNBC, LX, FEC+T, rads
2010 2.5cm tumor BRCA-, BMX,CMF
2011 LN mets, Gem/Carbo, surgery, rads
2012 lung mets, PI3Ki/taxo
2013 anti-PD-1
2014/15 Xeloda, IMMU-132, eribulin
Aug 2015 Keytruda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote megarita Quote  Post ReplyReply Direct Link To This Post Posted: Jun 26 2015 at 8:17am
Beth, Thank you for your thoughts and input. I'm glad your tumors are going slowly! 

To give an update she had a pluerex catheter put in to be able to drain the lung fluid which is helping, and is now waiting for the wash out period to happen so she can start the immu trial, (it seems like forever to wait four weeks when you can tell the symptoms are getting worse). We think were lucky to get into the immu 132 because her Dr said it is now closed to new patients.  I guess it will be another month or two before we know if it will help her. 

I'm curious what they recommended for you at the Block Center if you have had the appointment?

Best wishes,
Megan




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Post Options Post Options   Thanks (0) Thanks(0)   Quote CatWhispurrer Quote  Post ReplyReply Direct Link To This Post Posted: Jun 30 2015 at 7:25pm
I just started halavan so don't know yet.    Will let you know.    I am fighting brain mets too which seems to be responding to radiation.

Best to everyone!
Tina
Found lump 9/16/11, age 55, Diagnosed 10/27 IDC TN, LX/SNB 12/7/11, Stage 1, Grade 3, 1.8 cm, 0/3 nodes, BRCA-, DD A/C on 1/23/12, followed by DD Taxol. 3/14/14 Stage IV, 3/26/14 Paclitaxel
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