Efficacy And Safety Of Nanoparticle Albumin-Bound Paclitaxel For Treating Metastatic Breast Cancer: A Meta-Analysis

Objective: Clinical trials have reported conflicting results about the efficacy and toxicity of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) for treating metastatic breast cancer. This meta-analysis was performed to gain a clearer picture of the efficacy and safety of this drug. Methods: We systematically searched PubMed, Chinese National Knowledge Infrastructure (CNKI), Ovid, EMBASE and Cochrane literature databases for randomized controlled trials (RCTs) of nab-paclitaxel to treat metastatic breast cancer. Data on overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and incidence of adverse effects were meta-analyzed to yield pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CI). Potential heterogeneity was calculated using the Q statistic and I-2 value. Results: The meta-analysis included six RCTs involving 1614 patients. Nab-paclitaxel was associated with significantly higher ORR than were control drug treatments (OR 2.46, 95% CI 1.92 to 3.14, P < 0.00001). It was also associated with higher PFS than were control drug treatments (HR 0.83, 95% CI 0.73 to 0.94, P = 0.003). However, OS was similar for nab-paclitaxel and control treatments (HR 0.87, 95% CI 0.71 to 1.05, P = 0.14). Analysis of the six studies showed that nab-paclitaxel was associated with significantly higher risk of grade 3 sensory neuropathy than were control drug treatments (OR 1.82, 95% CI 1.21 to 2.74, P = 0.004). Conclusions: These findings suggest that nab-paclitaxel is associated with significantly higher ORR but also greater risk of toxicity than are other drug treatments for metastatic breast cancer.