Comparing the frequency and severity of nerve disease with eribulin versus paclitaxel before surgery in women with breast cancer

The study compared the frequency and severity of neuropathy (nerve damage) eribulin (Halaven) with paclitaxel (Taxol) given before surgery in women with operable breast cancer (BC). The study found that the frequency and severity of neuropathy were reduced in patients who received eribulin than in patients who received paclitaxel.

Neoadjuvant chemotherapy (NAC) is a treatment given to patients before surgery to decrease the tumor size. Choosing NAC depends on the cancer subtype and the patient's clinical status.

Paclitaxel is a chemotherapy drug and is known to be efficient. However, it has many side effects including peripheral neuropathy. Peripheral neuropathy involves damage to the nerves of the hands and feet and manifests as tingling and numbness to the hands and feet. It can be more serious such as burning pain or paralysis. Another chemotherapy drug, eribulin, has shown less frequent neuropathy. However, it may be less effective than paclitaxel in patients with BC. It is important to evaluate the frequency and severity of neuropathy of eribulin compared to paclitaxel in women with BC.

The study enrolled 121 patients with operable BC. Patients were randomly assigned to receive either eribulin followed by fluorouracil, epirubicin, and cyclophosphamide (FEC; group 1) or paclitaxel followed by FEC (group 2). Patients received either 4 cycles of eribulin or weekly paclitaxel for 12 weeks, followed by 4 cycles of FEC followed by breast surgery. Patients were followed up for an average of 54.2 months for group 1 and 51.4 months for group 2.

The overall response to treatment was significantly lower in group 1 (55.2%) compared to group 2 (77.2%). However, the survival rate without BC after 3 years was similar in group 1 (89.7%) compared to group 2 (86%).

Overall, peripheral neuropathy was significantly less common and less serious in group 1 compared to group 2. Group 1 had more severe low white blood cell counts than group 2. However, allergic reactions, rash, and nail damage were more common in group 2.  

The study concluded that eribulin was associated with less common and less serious neuropathy compared to paclitaxel in women with BC.

The study was conducted in Japan and does not cover the general population.