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Halaven No Better Than Xeloda for Previously Treated Metastatic Disease

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Halaven (chemical name: eribulin) is a chemotherapy medicine approved to treat metastatic breast cancer that has already been treated with other chemotherapy medicines.

Xeloda (chemical name: capecitabine) is a chemotherapy medicine often used in combination with other anticancer medicines. Typically, it’s used to treat metastatic disease that’s stopped responding to certain other chemotherapy medicines.

Metastatic breast cancer is advanced-stage cancer that has spread to parts of the body away from the breast -- the bones, liver, or brain, for example. Halaven is recommended to be used only after metastatic breast cancer has been treated with two standard types of chemotherapy medicines: an anthracycline and a taxane. Adriamycin (chemical name: doxorubicin) and Ellence (chemical name: epirubicin) are anthracyclines. Taxol (chemical name: paclitaxel), Taxotere (chemical name: docetaxel), and Abraxane (chemical name: albumin-bound or nab-paclitaxel) are taxanes.

A study has found that Halaven offers the same benefits as Xeloda for women diagnosed with metastatic disease that already has been treated with an anthracycline and a taxane.

The research was published online by the Journal of Clinical Oncology on Jan. 20, 2015. Read the abstract of "Phase III Open-Label Randomized Study of Eribulin Mysylate Versus Capecitabine in Patients With Locally Advanced or Metastatic Breast Cancer Previously Treated With an Anthracycline and a Taxane."

Halaven is made from a sea sponge. Like some other chemotherapy medicines, Halaven works by interfering with microtubulin, a component of cells. When both healthy and cancer cells divide, microtubulin acts as a building block for the structures that make sure the cell reproduces. Microtubulin also helps sort genetic material in the cell during cell division. So interfering with microtubulin can disrupt cell division and make cancer cells die. Halaven is classified as a microtubule inhibitor. Halaven is given intravenously.

Xeloda is an antimetabolite. Xeloda kills cancer cells by acting as a false building block in the cancer cells’ genes, causing the cancer cells to die as they get ready to divide. Xeloda is a pill taken by mouth.

Because some metastatic cancers stop responding to standard treatments such as anthracyclines and taxanes, researchers want to know which treatments would be best to try next.

In this study, the researchers randomly assigned 1,100 women diagnosed with metastatic breast cancer that had previously been treated with an anthracycline and a taxane to one of two treatments:

  • Halaven (544 women)
  • Xeloda (546 women)

The researchers wanted to know if one medicine would offer better overall survival or better progression-free survival.

Overall survival is how long a woman lives, with or without the cancer growing.

Progression-free survival is how long a woman lives without the cancer growing.

Median overall survival was:

  • 15.9 months for Halaven
  • 14.5 months for Xeloda

Median progression-free survival was:

  • 4.1 months for Halaven
  • 4.2 months for Xeloda

Median means that half the women had overall or progression-free survival that was longer than the times listed and half of the women had survival rates that were shorter than the times listed.

The objective response rates were:

  • 11.0% for Halaven
  • 11.5% for Xeloda

Objective response rate is the number of cancers that responded in some way to the treatment.

Like most chemotherapy medicines, both Halaven and Xeloda can cause side effects, some of them serious. Serious side effects were seen in:

  • 17.5% of women getting Halaven
  • 21.1% of women getting Xeloda

The most common side effects from Halaven were:

  • neutropenia (low-white blood cell count)
  • hair loss
  • neuropathy
  • nausea

The most common side effects from Xeloda were:

  • hand-foot syndrome
  • diarrhea
  • nausea

If you’ve been diagnosed with metastatic breast cancer that’s stopped responding to a chemotherapy regimen of an anthracycline and a taxane, you and your doctor may be considering a number of treatment options. Based on the results of this study, you can be reassured that if you select Halaven or Xeloda as your next medicine, you’ll likely get the same results. As you’re deciding on a next treatment, you and your doctor will take into account a number of factors, including your health history and your personal preferences. Together, you can make the best choice for you.

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