Incidence and relative risk of peripheral neuropathy in cancer patients treated with eribulin: a meta-analysis

// Ling Peng 1 , Yun Hong 2 , Xianghua Ye 3 , Peng Shi 4, 5 , Junyan Zhang 6 , Yina Wang 1 and Qiong Zhao 1 1 Department of Thoracic Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China 2 Department of Pharmacy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China 3 Department of Radiotherapy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China 4 Department of Medical Statistics, Children’s Hospital of Fudan University, Shanghai, China 5 Center for Evidence-Based Medicine, Fudan University, Shanghai, China 6 Bothwin Clinical Study Consultant, Seattle, WA, USA Correspondence to: Qiong Zhao, email: doczq.2008@hotmail.com Keywords: eribulin, peripheral neuropathy, incidence, relative risk, meta-analysis Received: July 10, 2017      Accepted: August 30, 2017      Published: September 19, 2017 ABSTRACT Background: Eribulin is a microtubule inhibitor, which is approved for the treatment of breast cancer. Peripheral neuropathy has been reported in the studies of eribulin, but the incidence and relative risk (RR) of eribulin-associated peripheral neuropathy varied greatly in cancer patients. The purpose of this meta-analysis was to determine the overall incidence and RR of eribulin-associated peripheral neuropathy in cancer patients. Materials and Methods: Pubmed database and Embase and abstracts presented at the American Society of Clinical Oncology (ASCO) meetings were systematically reviewed for primary studies. Eligible studies included prospective clinical trials and expanded access programs of cancer patients treated with eribulin. Statistical analyses were performed to calculate the incidences, RRs, and 95% confidence intervals (CIs). Results: Altogether, 4,849 patients from 19 clinical trials were selected for this meta-analysis. The incidences of all-grade and high-grade peripheral neuropathy were 27.5% (95% CI: 23.3–32.4%) and 4.7% (95% CI: 3.6–6.2%), respectively. The relative risks of peripheral neuropathy of eribulin compared to control were increased for all-grade (RR = 1.89, 95% CI: 1.10–3.25) but not statistically significant for high-grade (RR = 2.98, 95% CI: 0.71–12.42). Conclusions: The use of eribulin is associated with an increased incidence of peripheral neuropathy. The RR is increased for all-grade peripheral neuropathy.