Peng L, Bu Z, Ye X, Zhou Y, Zhao Q
Department of Thoracic Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Ultrasound, Zhejiang Hospital, Hangzhou, China.
Eur J Cancer Care (Engl). 2017 Sep;26(5). doi: 10.1111/ecc.12407. Epub 2015 Nov 4.
Nab-paclitaxel, a Cremophor EL-free formulation of paclitaxel, is used to treat various malignancies. Peripheral neuropathy is one of its major toxicities, although the overall incidence remains unclear. We performed a meta-analysis to calculate the incidence of peripheral neuropathy in cancer patients treated with nab-paclitaxel and to compare the relative risk (RR) with conventional taxanes. The electronic databases were searched for relevant clinical trials. Eligible studies included phase II and III prospective clinical trials of cancer patients treated with nab-paclitaxel with toxicity profile on peripheral neuropathy. Statistical analyses were done to calculate summary incidences, RRs and 95% confidence intervals (CI), using fixed-effects or random-effects models based on the heterogeneity of the included studies. Nineteen trials were selected for the meta-analysis, yielding a total of 2878 cancer patients. The overall incidences of peripheral neuropathy (all-grade) was 51.0% (95% CI: 45.1-57.6%), and that of high-grade peripheral neuropathy was 12.4% (9.8-15.7%). The RRs of peripheral neuropathy of nab-paclitaxel compared to taxanes were not increased for all-grade and high-grade peripheral neuropathy. Nab-paclitaxel is associated with an increased risk of developing peripheral neuropathy. Future clinical studies are still needed to investigate the risk reduction and possible use of nab-paclitaxel.
白蛋白结合型紫杉醇是一种不含聚氧乙烯蓖麻油的紫杉醇制剂，用于治疗多种恶性肿瘤。外周神经病变是其主要毒性之一，尽管总体发生率尚不清楚。我们进行了一项荟萃分析，以计算接受白蛋白结合型紫杉醇治疗的癌症患者外周神经病变的发生率，并将相对风险（RR）与传统紫杉烷类药物进行比较。通过检索电子数据库查找相关临床试验。符合条件的研究包括关于接受白蛋白结合型紫杉醇治疗的癌症患者外周神经病变毒性特征的II期和III期前瞻性临床试验。根据纳入研究的异质性，使用固定效应或随机效应模型进行统计分析，以计算汇总发生率、RR和95%置信区间（CI）。选择了19项试验进行荟萃分析，共有2878例癌症患者。外周神经病变（所有级别）的总体发生率为51.0%（95%CI：45.1 - 57.6%），高级别外周神经病变的发生率为12.4%（9.8 - 15.7%）。与紫杉烷类药物相比，白蛋白结合型紫杉醇在所有级别和高级别外周神经病变方面的RR并未增加。白蛋白结合型紫杉醇与发生外周神经病变风险增加相关。未来仍需要进行临床研究以探讨降低风险以及白蛋白结合型紫杉醇的可能用途。
