Li Yong, Lu Xiaoju, Lin Qimou, Li Weiwen
Department of Breast Surgery, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen City, Guangdong Province, P.R. China.
Department of Critical Care Medicine, Jiangmen People's Hospital, Jiangmen City, Guangdong Province, P.R. China.
J Int Med Res. 2020 Aug;48(8):300060520943473. doi: 10.1177/0300060520943473.
This study compared the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) with conventional taxanes as neoadjuvant chemotherapy for breast cancer.
We searched the literature using PubMed, the Cochrane Library, and Web of Science from their inception to December 15, 2019 based on predetermined inclusion and exclusion criteria. The relevant studies compared pathologic complete response (pCR) and adverse event rates.
The meta-analysis included five studies and 2335 patients. Compared with conventional taxanes, neoadjuvant chemotherapy with nab-paclitaxel was associated with a higher pCR rate (odds ratio [OR] = 1.39, 95% confidence interval [CI] = 1.16-1.67), especially among patients with triple-negative breast cancer or Ki67 indices of >20%. Pooled outcomes also revealed better event-free survival in the nab-paclitaxel group (hazard ratio = 0.69, 95% CI = 0.57-0.85). However, all-grade (OR = 2.17, 95% CI = 1.38-3.40) and grade ≥3 peripheral sensory neuropathy (OR = 3.92, 95% CI = 2.44-6.28) were more frequent in the nab-paclitaxel group.
This meta-analysis implied that nab-paclitaxel more effectively improved pCR than conventional taxanes. Nab-paclitaxel may have greater benefits in patients with triple-negative breast cancer. However, additional attention is required for the early diagnosis and management of peripheral sensory neuropathy.
本研究比较了纳米白蛋白结合型紫杉醇（nab-紫杉醇）与传统紫杉类药物作为乳腺癌新辅助化疗的疗效和安全性。
我们根据预先设定的纳入和排除标准，检索了PubMed、Cochrane图书馆和Web of Science自创建至2019年12月15日的文献。相关研究比较了病理完全缓解（pCR）率和不良事件发生率。
荟萃分析纳入了五项研究，共2335例患者。与传统紫杉类药物相比，nab-紫杉醇新辅助化疗的pCR率更高（优势比[OR]=1.39，95%置信区间[CI]=1.16-1.67），尤其是在三阴性乳腺癌患者或Ki67指数>20%的患者中。汇总结果还显示nab-紫杉醇组的无事件生存率更好（风险比=0.69，95%CI=0.57-0.85）。然而，nab-紫杉醇组的所有级别（OR=2.17，95%CI=1.38-3.40）和≥3级周围感觉神经病变（OR=3.92，95%CI=2.44-6.28）更为常见。
这项荟萃分析表明，nab-紫杉醇比传统紫杉类药物更有效地提高了pCR率。nab-紫杉醇可能对三阴性乳腺癌患者有更大益处。然而，需要对周围感觉神经病变的早期诊断和管理给予更多关注。
