Efficacy and safety of nab-paclitaxel plus platinum in non-small cell lung cancer: a meta-analysis

Tianying Tan; Shuangshuang Li; Wenting Hu; Tinghui Yue; Qi Zeng; Xingling Zeng; Xiaochao Chen; Xiangdong Zhao; Tianbao Xiao

doi:10.3389/fmed.2023.1139248

Efficacy and safety of nab-paclitaxel plus platinum in non-small cell lung cancer: a meta-analysis

Front Med (Lausanne). 2023 Jul 24:10:1139248. doi: 10.3389/fmed.2023.1139248. eCollection 2023.

Authors

Tianying Tan¹, Shuangshuang Li¹, Wenting Hu¹, Tinghui Yue¹, Qi Zeng², Xingling Zeng³, Xiaochao Chen⁴, Xiangdong Zhao⁵, Tianbao Xiao⁶

Affiliations

¹ College of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
² School of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
³ Clinical Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
⁴ Colorectal and Anal Surgery, Chengdu Anorectal Hospital, Chengdu, Sichuan, China.
⁵ Colorectal and Anal Surgery, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
⁶ Colorectal and Anal Surgery, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.

Abstract

Purpose: This meta-analysis was exerted in assessing the anticancer efficacy and safety of nab-paclitaxel (nab-P) when combined with platinum compound agents for therapy in patients with non-small cell lung cancer (NSCLC).

Method: We systematically searched the following seven electronic databases: PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wan Fang, and China Science and Technology Journal Data. Randomized comparative clinical [randomized controlled clinical trial (RCT)] studies on nab-P plus platinum and carboplatin or cisplatin in combination with conventional chemotherapy agents or traditional paclitaxel were searched.

Results: A total of 19 RCT studies involving 6,011 patients were analyzed. The primary outcome includes the overall response rate (ORR), overall survival (OS), and progression-free survival (PFS). The secondary outcome includes adverse events (AEs). Nab-P combined with platinum (carboplatin/cisplatin) had a better ORR [odds ratio (OR) = 1.66, 95% confidence interval (CI) (1.34, 2.05), p < 0.001] and improved PFS [hazard ratio (HR) = 0.84, 95% CI: (0.74, 0.94), p = 0.01] and OS [HR = 0.86, 95% CI: (0.78, 0.96), p = 0.008] in NSCLC patients. ORR [OR = 2.18, 95% CI: (1.07, 4.43)], PFS [HR = 0.62, 95% CI: (0.40, 0.97)], and OS [HR = 0.63, 95% CI: (0.49, 0.81)] were significantly improved among patients aged >70 years, and ORR [OR = 1.80, 95% CI: (1.20, 2.70)] and PFS [HR = 0.74, 95% CI: (0.56, 0.97)] were significantly elevated with SCC rate ≥65% in NSCLC patients (all p > 0.05). Among the adverse effects, the prevalence of neutropenia, neuralgia, and arthralgia/myalgia (≥ grade 3) compared to that of the control group. On the other hand, the prevalence of anemia and thrombocytopenia was higher in the nab-P plus platinum (carboplatin/cisplatin) compared to that of controls. It is worth noting that fatigue did not show statistical significance.

Conclusion: Nab-P in combination with carboplatin/cisplatin regimen improves efficacy and tolerability in patients with NSCLC.

Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022288499.

Keywords: chemotherapy; efficacy; meta-analysis; nab-paclitaxel; non-small cell lung cancer; safety.

Publication types

Systematic Review