Comparative efficacy and safety of eribulin versus paclitaxel in breast cancer: a systematic review and meta-analysis

We conducted a meta-analysis of published randomized controlled trials to compare the effectiveness and safety of eribulin versus paclitaxel for patients with breast cancer. We systematically searched multiple databases including Cochrane, PubMed, Medline, and Embase. The primary outcomes analyzed were overall survival (OS), complete response (CR), partial response (PR), stable disease (SD), and adverse events (AEs). These outcomes were evaluated using RevMan5.3 software. A total of 5 studies were included in the analysis. Compared to paclitaxel plus other chemotherapy drugs, eribulin plus other chemotherapy drugs not only extended the overall survival of patients but also improved the disease control rate (DCR) [risk ratio (RR) 0.98, (95% confidence intervals (CI): 0.70, 1.38), <i>p</i> = 0.92]. Hematological system diseases [RR 1.18 (95% CI: 1.07, 1.31), <i>p</i> = 0.002] were the most frequently observed adverse event with eribulin, while paclitaxel was more likely to cause nervous system lesion [RR 0.66 (95% CI: 0.54, 0.80), <i>p</i> &lt; 0.0001]. Compared with paclitaxel plus other chemotherapy drugs, eribulin plus other chemotherapy drugs can also prolong the PFS and OS of BC patients. Our recommendation is to use eribulin plus other chemotherapy drugs to treat advanced BC and to continuously monitor and manage the drug-related adverse events. In order to further explore the efficacy and safety of eribulin and paclitaxel in treating breast cancer, our study conducted the first meta-analysis on this topic. The objective was to compare the effectiveness of eribulin and paclitaxel and provide valuable insights for clinicians. Eribulin plus other chemotherapy drugs significantly prolonged OS or improved DCR in patients with BC, which was no statistical difference compared with paclitaxel (P＞0.05). Eribulin not only can be used as a first-line treatment for advanced breast cancer but also can be used to treat patients who are resistant to taxane, so the choice is wider. In terms of adverse drug reactions, Eribulin is easy to cause hematological system diseases, especially neutropenia, while paclitaxel is prone to cause nervous system lesions. Both of them can cause impaired digestive function and skin and hair damage. Our recommendation is to select appropriate chemotherapy drugs to treat different states of BC patients and to prevent and manage AEs after using drugs.