Efficacy and safety of nanoparticle-albumin-bound paclitaxel compared with solvent-based taxanes for metastatic breast cancer: A meta-analysis

Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, 03760, Republic of Korea. Department of Pharmacy, Ewha Womans University Mokdong Hospital, Seoul, 07985, Republic of Korea. Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea. College of Pharmacy, Ewha Womans University, Seoul, 03760, Republic of Korea. Department of Pharmacy, National Medical Center, Seoul, 04564, Republic of Korea. Division of Life & Pharmaceutical Science, Ewha Womans University, Seoul, 03760, Republic of Korea. Department of Pharmacy, Ewha Womans University Seoul Hospital, Seoul, 07985, Republic of Korea. Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, 03760, Republic of Korea. sandy.rhie@ewha.ac.kr. Department of Pharmacy, Ewha Womans University Mokdong Hospital, Seoul, 07985, Republic of Korea. sandy.rhie@ewha.ac.kr. Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea. sandy.rhie@ewha.ac.kr. College of Pharmacy, Ewha Womans University, Seoul, 03760, Republic of Korea. sandy.rhie@ewha.ac.kr. Division of Life & Pharmaceutical Science, Ewha Womans University, Seoul, 03760, Republic of Korea. sandy.rhie@ewha.ac.kr.

Scientific reports. 2020;10(1):530
PICO Summary

Population

Patients with metastatic breast cancer, (5 studies), (n= 1,554).

Intervention

Nanoparticle albumin-bound (nab)-paclitaxel chemotherapy, (n=774).

Comparison

Solvent-based (sb)-taxanes chemotherapy: sb-paclitaxel, (n=606) and docetaxel, (n=174).

Outcome

When compared to sb-paclitaxel, nab-paclitaxel showed significant beneficial effects in terms of overall response rate (ORR) (OR 2.39), disease control rate (DCR) (OR 1.89), and progression-free survival (PFS) (HR 0.75). Nab-paclitaxel also showed significantly longer overall survival (OS) (HR 0.73) than docetaxel. Adverse events (AEs) and dose discontinuation rate (DDR) were comparable between the two arms.
Abstract
The curative effects of nanoparticle albumin-bound (nab)-paclitaxel in the first-line treatment of metastatic breast cancer (MBC) are still controversial, with even more after the removal of marketing approval of indication of bevacizumab. Five electronic databases and the related resources were searched for eligible randomized clinical trials (RCTs) without year and language restrictions to perform a meta-analysis. The studies were comparing the efficacy and safety between nab-paclitaxel chemotherapy versus solvent-based (sb)-taxanes chemotherapy such as sb-paclitaxel and docetaxel. The primary end points were overall response rate (ORR) and disease control rate (DCR). Secondary end points were progression-free survival (PFS), overall survival (OS), adverse events (AEs), and dose discontinuation rate (DDR). Five RCTs (1,554 patients) were finally identified from 1,902 studies. When compared to sb-paclitaxel, nab-paclitaxel showed significant beneficial effects in terms of ORR (OR 2.39, 95% CI 1.69-3.37, p < 0.001), DCR (OR 1.89, 95% CI 1.07-3.35, p = 0.03), and PFS (HR 0.75, 95% CI 0.62-0.90, p = 0.002). Nab-paclitaxel also showed significantly longer OS (HR 0.73, 95% CI 0.54-0.99, p = 0.04) than docetaxel. AEs and DDR were comparable between the two arms. Using nab-paclitaxel could significantly improve efficacy with comparable toxicities in the treatment of MBC.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine