OBJECTIVES: To conduct a systemic review of published literature on the comparative efficacy and safety of eribulin versus other chemotherapies in patients with locally advanced breast cancer (LABC) or metastatic breast cancer (MBC).

METHODS: Embase, Medline, Medline In-process and the Cochrane databases were searched using the OVID platform till May 2022. Randomized controlled trials (RCTs) of LABC or MBC patients comparing eribulin mono or combination therapy to other chemotherapies were included. Comparators evaluated in the included trials were ixabepilone, capecitabine, gemcitabine, paclitaxel, vinorelbine and treatment of physician’s choice. The pooled effect estimates for the overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs) were estimated using the random-effect model in case of substantial heterogeneity (I² >50%). Comprehensive Meta-Analysis (CMA) software package was used to perform meta-analysis.

RESULTS: Of the 1,065 studies identified in the database search, six RCTs involving 2,665 patients were included for analysis. Meta-analysis results showed statistically significant OS (Hazard ratio [HR], 0.88; 95% CI, 0.80 to 0.97; 4 studies) with eribulin therapy compared to other chemotherapies. The pooled effect estimates for PFS (HR, 0.94; 95% CI, 0.85 to 1.03; 4 studies) and ORR (Odds ratio [OR], 1.75; 95% CI, 1.11 to 2.77; 6 studies) also favored eribulin therapy. Patients in the eribulin arm demonstrated a non-significant risk for grade 3/4 neutropenia (Risk ratio [RR]: 1.82; 95% CI, 0.69 to 4.84), peripheral neuropathy (RR: 2.50; 95% CI, 0.51 to 12.13), fatigue (RR: 0.29; 95% CI, 0.06 to 1.49), and anemia (RR: 1.07; 95% CI, 0.61 to 1.89).

CONCLUSIONS: Findings from this systemic review showed significant survival benefit and tolerable safety profile of eribulin therapy for LABC or MBC patients.