Supporting women whose lives have been touched by breast cancer

Capecitabine and eribulin experience

By mrb

Capecitabine (Xeloda) and eribulin (Halaven) are chemotherapy treatments currently used in the UK for secondary/metastatic bc, usually after other chemos such as EC (epirubicin+cyclophosphamide) or Taxol (paclitaxel) have been given previously. I was on capecitabine for two years (2011-2012) and had 7 cycles of eribulin in summer 2013.

Unlike some other chemos, such as EC which is restricted to only 6 cycles, capecitabine and eribulin chemos can be continued for as long as they are effective. I didn't have any problems with white blood count with either of these treatments.

Capecitabine is taken as tablets, usually for 2 weeks out of 3, though I was on a 1-week-on/1-week-off dosing schedule. The commonest side effect is palmar-plantar (hand-foot) syndrome, sore and cracked skin. This can also affect fingernails and toenails, which grow very slowly and become thick and unsightly. My hair grew more slowly, and thinned on the crown of my head. I had a few digestive problems on some early cycles of capecitabine, but these soon settled down and it didn't feel like being on chemo at all.

Eribulin is given by IV, 2 weeks out of 3, so it feels more like a conventional chemo. Some patients do not lose their hair, but unfortunately I lost almost all my head hair and my eyebrows/eyelashes. I also had fatigue with eribulin, which was affecting daily living by about the 6th cycle. Thankfully I have now recovered from this fatigue, 3 months after I finished eribulin. This chemo was kind to my nails and skin. I did have a sore tongue on some cycles, but this can be managed with a prescription mouthwash. Some hospitals prescribe steroids with eribulin, but mine does not. An anti-nausea drug is often given by IV immediately before the eribulin. On my first treatment I was given IV metoclopramide, and the combination of this with eribulin sent me to sleep for most of that day! I persuaded the medical team not to bother with IV anti-emetics, and took prescribed domperidone tablets if I felt queasy.

It is possible to have a break from capecitabine (I requested this after two years, my tumour markers had stabilised and I had had enough of the skin problems) but my team are reluctant to give me this again at the moment. Possibly this could be a funding issue, I guess. Eribulin is currently available to English NHS patients via the Cancer Drugs Fund, but the situation could change.