Efficacy and safety of nanoparticle albumin-bound paclitaxel in non-small cell lung cancer: a systematic review and meta-analysis

Nanoparticle albumin-bound paclitaxel (Nab-paclitaxel) offer more efficient paclitaxel delivery into tumor cells with fewer side effects than conventional chemotherapies. However, whether the efficacy of Nab-paclitaxel for non-small cell lung cancer (NSCLC) patients is age-related remains unknown. We performed this meta-analysis to evaluate the anticancer efficacy and safety of Nab-paclitaxel in NSCLC. Hazard ratios (HRs) or rate ratios (RRs) with corresponding 95% confidence intervals (CIs) for outcomes were retrieved. Thirteen high-quality studies with 4613 patients were included, of which five were comparative trials comparing nab-paclitaxel plus carboplatin (nab-P/C) with solvent-based paclitaxel plus carboplatin (sb-P/C), and the others were non-comparative trials investigating the nab-paclitaxel efficacy. Pooled comparative trial estimates showed that nab-P/C significantly improved overall response rates ([RR]: 1.31) and prolonged progression-free survival (PFS) (HR: 0.89) and overall survival (OS) (HR: 0.93) compared with the control. However, meta-analysis of the younger subgroup indicated that PFS (HR: 93) and OS (HR: 96) were similar between the two arms. Regarding safety, nab-paclitaxel significantly increased risk for grade >= 3 anaemia. For non-hematological adverse events, grade >= 3 sensory neuropathy and arthralgia occurred more frequently in the control arm than in the experimental arm. In conclusion: Nab-paclitaxel is effective and safe for NSCLC patients, especially the elderly.