■纳米颗粒白蛋白结合型紫杉醇(nab-pacytaxel)在晚期非小细胞肺癌(NSCLC)中的疗效和安全性不一致。
■我们进行了系统评价和荟萃分析,包括比较和非比较试验以及队列研究,评估nab-紫杉醇在晚期NSCLC中的疗效和安全性。搜索覆盖了PubMed,中部,Scopus,和ClinicalTrials.gov,直到2022年10月。疗效结果(OR,PR,进行性疾病,操作系统,和PFS)和安全性结果(中性粒细胞减少,白细胞减少症,血小板减少症,贫血,和感觉神经病变)进行分析。
■我们的荟萃分析包括来自35项研究的数据(9项随机对照试验,2项队列研究,和24项非比较研究)。Nab-紫杉醇显著提高OR率(RRRCT1.35[95%CI1.19,1.53],I2=36.6%;RR队列1.67[95%CI1.30,2.14],I2=4.3%)和PR率(RRRCT1.34[95%CI1.18,1.53],I2=38.8%;RR队列1.59[95%CI1.22,2.07],I2=19.4%)与对照组相比。它进一步证明了在鳞状细胞癌和作为二线治疗中更明显的益处。来自随机对照试验的汇总证据也表明OS有所改善(HR0.90[95%CI0.81,0.99],I2=9.2%)和PFS(HR0.84[95%CI0.76,0.93],I2=14.5%)然而,nab-紫杉醇治疗减少不良事件的证据不足,研究选择和检测中的偏见可能会影响结果。
■Nab-紫杉醇增强OR,PR,PFS,并略微改善晚期非小细胞肺癌的OS,特别是在先前化疗的患者中。需要进一步研究以确定其安全优势。
UNASSIGNED: The efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in advanced non-small cell lung cancer (NSCLC) have yielded inconsistent findings.
UNASSIGNED: We conducted a systematic review and meta-analysis, including comparative and noncomparative trials and cohort studies, to assess the efficacy and safety of nab-paclitaxel in advanced NSCLC. The search covered PubMed, CENTRAL, Scopus, and ClinicalTrials.gov until October 2022. Efficacy outcomes (OR, PR, progressive disease, OS, and PFS) and safety outcomes (neutropenia, leukopenia, thrombocytopenia, anemia, and sensory neuropathy) were analyzed.
UNASSIGNED: Our meta-analysis included data from 35 studies (9 RCTs, 2 cohort studies, and 24 noncomparative studies). Nab-paclitaxel significantly improved OR rate (RRRCT 1.35 [95% CI 1.19, 1.53], I2 = 36.6%; RRcohort 1.67 [95% CI 1.30, 2.14], I2 = 4.3%) and PR rate (RRRCT 1.34 [95% CI 1.18, 1.53], I2 = 38.8%; RRcohort 1.59 [95% CI 1.22, 2.07], I2 = 19.4%) compared to the control group. It further demonstrated more pronounced benefits in squamous cell carcinoma and as a second-line treatment. Pooled evidence from the RCTs also indicated improved OS (HR 0.90 [95% CI 0.81, 0.99], I2 = 9.2%) and PFS (HR 0.84 [95% CI 0.76, 0.93], I2 = 14.5%) However, evidence on the reduction of adverse events with nab-paclitaxel treatment was insufficient, and biases in study selection and detection may have influenced the results.
UNASSIGNED: Nab-paclitaxel enhances OR, PR, PFS, and marginally improves OS in advanced NSCLC, particularly in patients with prior chemotherapy. Further research is needed to establish its safety advantages.