Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Ann Pharmacother. 2022 Aug;56(8):898-909. doi: 10.1177/10600280211058385. Epub 2021 Dec 28.
Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is an innovative form of taxane that has superior antitumor effects; however, the safety profile between nab-paclitaxel and traditional taxanes remains controversial.
To determine the burden of adverse events (AEs) in patients with multiple malignancies receiving nab-paclitaxel compared with that in patients receiving traditional taxanes.
Randomized clinical trials comparing nab-paclitaxel with traditional taxanes (solvent-based paclitaxel [sb-paclitaxel] or docetaxel) in the treatment of primary solid-organ malignancies were included if AEs were reported as an outcome. Statistical analyses were conducted to calculate the summary odds ratio (OR) of the relevant adverse outcomes related to nab-paclitaxel and traditional taxanes. Prespecified subgroup analyses based on intervention and doses, primary tumor sites, and different ethnic groups were also performed.
Twelve clinical trials were included in the meta-analysis. Grade 3/4 anemia, thrombocytopenia, and neurotoxicity were more frequent with nab-paclitaxel than with traditional taxanes. Nab-paclitaxel at 100 or 125 mg/m/w dosage was associated with fewer or similar grade 3/4 specific AEs. Allergy was less common with nab-paclitaxel. The median recovery times of neurotoxicity were 25, 64, and 37 days in patients receiving nab-paclitaxel, sb-paclitaxel, and docetaxel, respectively. Elevated incidences of specific AEs were more common in breast cancer and non-Asian patients than in other malignancies and ethnic groups, respectively.
Nab-paclitaxel increased the risk of hematologic and non-hematologic AEs in general, but anaphylaxis was less common, and the recovery duration of neurotoxicity was shorter. Weekly administration of nab-paclitaxel at a lower dosage provided better tolerance.
纳米白蛋白结合紫杉醇（nab-紫杉醇）是一种新型紫杉醇，具有优越的抗肿瘤作用；然而，nab-紫杉醇与传统紫杉醇之间的安全性特征仍存在争议。
确定接受 nab-紫杉醇治疗的多种恶性肿瘤患者与接受传统紫杉醇治疗的患者的不良事件（AE）负担。
纳入了比较 nab-紫杉醇与传统紫杉醇（溶剂型紫杉醇[sb-紫杉醇]或多西紫杉醇）治疗原发性实体恶性肿瘤的随机临床试验，如果 AE 作为结局报告。进行了统计分析，以计算与 nab-紫杉醇和传统紫杉醇相关的相关不良结局的综合优势比（OR）。还根据干预措施和剂量、原发肿瘤部位和不同种族进行了预设的亚组分析。
荟萃分析纳入了 12 项临床试验。nab-紫杉醇组比传统紫杉醇组更常发生 3/4 级贫血、血小板减少和神经毒性。nab-紫杉醇 100 或 125mg/m/w 剂量与较少或相似的 3/4 级特定 AE 相关。nab-紫杉醇组过敏较少见。接受 nab-紫杉醇、sb-紫杉醇和多西紫杉醇治疗的患者神经毒性的中位恢复时间分别为 25、64 和 37 天。nab-紫杉醇在乳腺癌和非亚洲患者中引起特定 AE 的发生率较高，而在其他恶性肿瘤和种族中则较低。
nab-紫杉醇总体上增加了血液学和非血液学 AE 的风险，但过敏反应较少见，神经毒性的恢复时间较短。每周给予较低剂量的 nab-紫杉醇可提供更好的耐受性。
