Evaluation of the Clinical Outcome of Nab-paclitaxel on Multiple Primary Malignancies: A Systematic Review and Meta-analysis

Document Type : Review Article


1 Department of Pathology, Faculty of medicine, Sari Branch, Islamic Azad University, Sari, Iran

2 JKKM College of Pharmacy, Tamil Nadu Dr. M.G.R Medical University, Tamil Nadu, India

3 Department of Pharmacology and Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of General Surgery, School of Medicine, Arak University of Medical Sciences, Arak, Iran


Background and aim: In the present study, an attempt has been made to analyze the side effects of nab-paclitaxel compared to sb-paclitaxel and docetaxel. The present study aimed to evaluate the clinical outcome of Nab-paclitaxel on Multiple primary malignancies.
Material and methods: All articles published in international databases such as PubMed, Scopus, Science Direct, ISI Web of knowledge, and Embase between 2012 to July 2022 are included. 95% confidence interval on odds ratio were done with the fixed effect model and Mantel-Haenszel method. Meta-analysis data collected from selected studies were performed using Stata/MP.V17 software.
Results: In the initial review, duplicate studies were eliminated, abstracts of 311 studies were reviewed, two authors reviewed the full text of 43 studies, and finally, nine studies were selected. The odds ratio of treatment termination and treatment delay due to adverse events between Nab-paclitaxel and the control group was 0.72 (OR, 95% CI 0.53, 0.92; p=0.00) and -0.52 (OR, 95% CI -0.69, -0.35; p=0.00). The odds ratio of deaths due to treatment-related adverse events between Nab-paclitaxel and the control group was 0.37 (OR, 95% CI 0.11, 0.63; p=0.01).
Conclusions: According to the present meta-analysis, hematological and non-hematological side effects were higher in the group receiving nab-paclitaxel compared to the group receiving sb-paclitaxel and docetaxel.


Main Subjects

[1]        Mosca L, Ilari A, Fazi F, Assaraf YG, Colotti G. Taxanes in cancer treatment: Activity, chemoresistance and its overcoming. Drug Resistance Updates. 2021;54:100742. https://doi.org/10.1016/j.drup.2020.100742.
[2]        Amaya C, Smith ER, Xu XX. Low Intensity Ultrasound as an Antidote to Taxane/Paclitaxel-induced Cytotoxicity. Journal of Cancer. 2022;13(7):2362-73. https://doi.org/10.7150%2Fjca.71263.
[3]        van Eerden RA, Mathijssen RH, Koolen SL. Recent clinical developments of nanomediated drug delivery systems of taxanes for the treatment of cancer. International Journal of Nanomedicine. 2020;15:8151-66. https://doi.org/10.2147%2FIJN.S272529.
[4]        Xie F, Chen R, Zhang L, Yin Z, Zhu Q, You S, Jiang C, Li Y, Li S, Zha X, Wang J. Efficacy of two-weekly nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy for breast cancer. Nanomedicine. 2019;14(12):1595-603. https://doi.org/10.2217/nnm-2018-0485.
[5]        De Luca R, Profita G, Cicero G. Nab-paclitaxel in pretreated metastatic breast cancer: evaluation of activity, safety, and quality of life. OncoTargets and therapy. 2019;12:1621-27. https://doi.org/10.2147%2FOTT.S191519.
[6]        He F, Liu J, Shen X, Wang Z, Li Q, Li G. Adverse event profile for nanoparticle albumin-bound paclitaxel compared with solvent-based taxanes in solid-organ tumors: a systematic review and meta-analysis of randomized clinical trials. Annals of Pharmacotherapy. 2022;56(8):898-909. https://doi.org/10.1177/10600280211058385.
[7]        Desai N, Trieu V, Yao Z, Louie L, Ci S, Yang A, Tao C, De T, Beals B, Dykes D, Noker P. Increased antitumor activity, intratumor paclitaxel concentrations, and endothelial cell transport of cremophor-free, albumin-bound paclitaxel, ABI-007, compared with cremophor-based paclitaxel. Clinical cancer research: an official journal of the American Association for Cancer Research. 2006;12(4):1317-24.https://doi.org/10.1158/1078-0432.CCR-05-1634.
[8]        Adrianzen Herrera D, Ashai N, Perez-Soler R, Cheng H. Nanoparticle albumin bound-paclitaxel for treatment of advanced non-small cell lung cancer: an evaluation of the clinical evidence. Expert Opinion on Pharmacotherapy. 2019;20(1):95-102. https://doi.org/10.1080/14656566.2018.1546290.
[9]        Yamamoto Y, Kawano I, Iwase H. Nab-paclitaxel for the treatment of breast cancer: efficacy, safety, and approval. OncoTargets and therapy. 2011;4:123-36. https://doi.org/10.2147%2FOTT.S13836.
[10] Liu Y, Ye G, Yan D, Zhang L, Fan F, Feng J. Role of nab-paclitaxel in metastatic breast cancer: a meta-analysis of randomized clinical trials. Oncotarget. 2017;8(42):72950-58. https://doi.org/10.18632%2Foncotarget.18900.
[11] Jotte RM, Cappuzzo F, Vynnychenko I, Stroyakovskiy D, Abreu DR, Hussein MA, Soo RA, Conter HJ, Kozuki T, Silva C, Graupner V. IMpower131: Primary PFS and safety analysis of a randomized phase III study of atezolizumab+ carboplatin+ paclitaxel or nab-paclitaxel vs carboplatin+ nab-paclitaxel as 1L therapy in advanced squamous NSCLC. J clin oncol. 2018;36(18 suppl):LBA9000.
[12] Reck M, Socinski MA, Cappuzzo F, Orlandi F, Stroyakovskii D, Nogami N, Rodríguez-Abreu D, Moro-Sibilot D, Thomas CA, Barlesi F, Finley G. Primary PFS and safety analyses of a randomized phase III study of carboplatin+ paclitaxel+/− bevacizumab, with or without atezolizumab in 1L non-squamous metastatic NSCLC (IMPOWER150). Annals of Oncology. 2017;28:xi31. https://doi.org/10.1093/annonc/mdx760.002.
[13] West H, McCleod M, Hussein M, Morabito A, Rittmeyer A, Conter HJ, Kopp HG, Daniel D, McCune S, Mekhail T, Zer A. Atezolizumab in combination with carboplatin plus nab-paclitaxel chemotherapy compared with chemotherapy alone as first-line treatment for metastatic non-squamous non-small-cell lung cancer (IMpower130): a multicentre, randomised, open-label, phase 3 trial. The Lancet Oncology. 2019;20(7):924-37. https://doi.org/10.1016/S1470-2045(19)30167-6.
[14] Schmid P, Rugo HS, Adams S, Schneeweiss A, Barrios CH, Iwata H, Diéras V, Henschel V, Molinero L, Chui SY, Maiya V. Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet Oncology. 2020;21(1):44-59. https://doi.org/10.1016/S1470-2045(19)30689-8.
[15] Selçuk AA. A guide for systematic reviews: PRISMA. Turkish archives of otorhinolaryngology. 2019;57(1):57-8. https://doi.org/10.5152%2Ftao.2019.4058.
[16] Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JA. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Bmj. 2011;343. https://doi.org/10.1136/bmj.d5928.
[17] Ciruelos E, Apellániz-Ruiz M, Cantos B, Martinez-Jáñez N, Bueno-Muiño C, Echarri MJ, Enrech S, Guerra JA, Manso L, Pascual T, Dominguez C. A Pilot, Phase II, Randomized, Open‐Label Clinical Trial Comparing the Neurotoxicity of Three Dose Regimens of Nab‐Paclitaxel to That of Solvent‐Based Paclitaxel as the First‐Line Treatment for Patients with Human Epidermal Growth Factor Receptor Type 2-Negative Metastatic Breast Cancer. The Oncologist. 2019;24(11):e1024-33. https://doi.org/10.1634/theoncologist.2017-0664.
[18] Sridhar SS, Blais N, Tran B, Reaume MN, North SA, Stockler MR, Chi KN, Fleshner NE, Liu G, Robinson JW, Mukherjee SD. Efficacy and safety of nab-paclitaxel vs paclitaxel on survival in patients with platinum-refractory metastatic urothelial cancer: the Canadian Cancer Trials Group BL. 12 Randomized Clinical Trial. JAMA oncology. 2020;6(11):1751-8. https://doi.org/10.1001/jamaoncol.2020.3927.
[19] Kuwayama T, Nakamura S, Hayashi N, Takano T, Tsugawa K, Sato T, Kitani A, Okuyama H, Yamauchi H. Randomized multicenter phase II trial of neoadjuvant therapy comparing weekly Nab-paclitaxel followed by FEC with docetaxel followed by FEC in HER2− early-stage breast cancer. Clinical breast cancer. 2018;18(6):474-80. https://doi.org/10.1016/j.clbc.2018.06.012.
How to Cite this Article: Salehi Kahrizsangi F, Mehrafar N, Ghadami P, Rabiee F, Shariati Y. Evaluation of the Clinical Outcome of Nab-paclitaxel on Multiple Primary Malignancies: A Systematic Review and Meta-analysis. International Journal of Scientific Research in Dental and Medical Sciences. 2022;4(4):183-190.    https://doi.org/10.30485/IJSRDMS.2022.367947.1391.
 [20] Gianni L, Mansutti M, Anton A, Calvo L, Bisagni G, Bermejo B, Semiglazov V, Thill M, Chacon JI, Chan A, Morales S. Comparing neoadjuvant nab-paclitaxel vs paclitaxel both followed by anthracycline regimens in women with ERBB2/HER2-negative breast cancer—the evaluating treatment with neoadjuvant abraxane (ETNA) trial: a randomized phase 3 clinical trial. JAMA oncology. 2018;4(3):302-8.https://doi.org/10.1001/jamaoncol.2017.4612.
[21] Miles D, Cameron D, Bondarenko I, Manzyuk L, Alcedo JC, Lopez RI, Im SA, Canon JL, Shparyk Y, Yardley DA, Masuda N. Bevacizumab plus paclitaxel versus placebo plus paclitaxel as first-line therapy for HER2-negative metastatic breast cancer (MERiDiAN): A double-blind placebo-controlled randomised phase III trial with prospective biomarker evaluation. European journal of cancer. 2017;70:146-55. https://doi.org/10.1016/j.ejca.2016.09.024.
[22] Shitara K, Takashima A, Fujitani K, Koeda K, Hara H, Nakayama N, Hironaka S, Nishikawa K, Makari Y, Amagai K, Ueda S. Nab-paclitaxel versus solvent-based paclitaxel in patients with previously treated advanced gastric cancer (ABSOLUTE): an open-label, randomised, non-inferiority, phase 3 trial. The Lancet Gastroenterology & Hepatology. 2017;2(4):277-87. https://doi.org/10.1016/S2468-1253(16)30219-9.
[23] Furlanetto J, Jackisch C, Untch M, Schneeweiss A, Schmatloch S, Aktas B, Denkert C, Wiebringhaus H, Kümmel S, Warm M, Paepke S. Efficacy and safety of nab-paclitaxel 125 mg/m2 and nab-paclitaxel 150 mg/m2 compared to paclitaxel in early high-risk breast cancer. Results from the neoadjuvant randomized GeparSepto study (GBG 69). Breast Cancer Research and Treatment. 2017;163(3):495-506. https://doi.org/10.1007/s10549-017-4200-1.
[24] Rugo HS, Barry WT, Moreno-Aspitia A, Lyss AP, Cirrincione C, Leung E, Mayer EL, Naughton M, Toppmeyer D, Carey LA, Perez EA. Randomized phase III trial of paclitaxel once per week compared with nanoparticle albumin-bound nab-paclitaxel once per week or ixabepilone with bevacizumab as first-line chemotherapy for locally recurrent or metastatic breast cancer: CALGB 40502/NCCTG N063H (Alliance). Journal of Clinical Oncology. 2015;33(21):2361-9. https://doi.org/10.1200%2FJCO.2014.59.5298.
[25] Socinski MA, Bondarenko I, Karaseva NA, Makhson AM, Vynnychenko I, Okamoto I, Hon JK, Hirsh V, Bhar P, Zhang H, Iglesias JL. Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer: final results of a phase III trial. J Clin Oncol. 2012;30(17):2055-62.
[26] Postow MA, Hellmann MD. Adverse Events Associated with Immune Checkpoint Blockade. The New England journal of medicine. 2018;378(12):1165. https://doi.org/10.1056/nejmc1801663.
[27] Vasquez R, Jeong H, Florez-Pollack S, Rubinos LH, Lee SC, Pandya AG. What are the barriers faced by under-represented minorities applying to dermatology? A qualitative cross-sectional study of applicants applying to a large dermatology residency program. Journal of the American Academy of Dermatology. 2020;83(6):1770-3. https://doi.org/10.1016/j.jaad.2020.03.067.
[28] Habre M, Habre SB, Kourie HR. Dermatologic adverse events of checkpoint inhibitors: what an oncologist should know. Immunotherapy. 2016;8(12):1437-46. https://doi.org/10.2217/imt-2016-0074.
[29] Marinelli D, Mazzotta M, Pizzuti L, Krasniqi E, Gamucci T, Natoli C, Grassadonia A, Tinari N, Tomao S, Sperduti I, Sanguineti G. Neoadjuvant immune-checkpoint blockade in triple-negative breast cancer: Current evidence and literature-based meta-analysis of randomized trials. Cancers. 2020;12(9):2497. https://doi.org/10.3390/cancers12092497.
[30] Blum JL, Savin MA, Edelman G, Pippen JE, Robert NJ, Geister BV, Kirby RL, Clawson A, O'Shaughnessy JA. Phase II study of weekly albumin-bound paclitaxel for patients with metastatic breast cancer heavily pretreated with taxanes. Clinical breast cancer. 2007;7(11):850-6. https://doi.org/10.3816/CBC.2007.n.049.