Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis
ObjectiveTo systematically evaluate the efficacy and safety of albumin-bound paclitaxel and paclitaxel in the treatment of esophageal cancer.MethodsSeven databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database,...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1612678/full |
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| author | Jiayang Song Yu Xiong Yu Xiong Hao Liu Wei Zhang Zhongfu Tan Nanjiang Liu |
| author_facet | Jiayang Song Yu Xiong Yu Xiong Hao Liu Wei Zhang Zhongfu Tan Nanjiang Liu |
| author_sort | Jiayang Song |
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| description | ObjectiveTo systematically evaluate the efficacy and safety of albumin-bound paclitaxel and paclitaxel in the treatment of esophageal cancer.MethodsSeven databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, and China Biology Medicine disc) were searched for randomized controlled trials (RCTs) of albumin-bound paclitaxel and paclitaxel in the treatment of esophageal cancer. The search was conducted from database inception to February 2025. Literature quality was assessed using the Cochrane Risk of Bias Tool version 1 (RoB 1), and the systematic review and meta-analysis was performed using RevMan 5.4.1 and STATA18.ResultsEleven RCTs were included. Meta-analysis demonstrated that albumin-bound paclitaxel significantly improved objective response rate [ORR; relative risk (RR) = 1.67, 95% confidence interval (CI) [1.45, 1.92], p < 0.001, I2 = 0%] and disease control rate (DCR; RR = 1.69, 95% CI [1.43, 1.98], p < 0.001, I2 = 0%) compared to paclitaxel. It also showed superior improvements in serum tumor markers: cancer antigen 125 (CA125) [mean difference (MD) = −1.69, 95% CI [−2.73, −0.65], p < 0.001, I2 = 83%], Carbohydrate antigen 19-9 (CA199) (MD = −2.12, 95% CI [−3.39, −0.84], p = 0.001, I2 = 85%), and carcinoembryonic antigen (CEA) (MD = −2.01, 95% CI [−2.53, −1.50], p < 0.001, I2 = 99%), although Squamous Cell Carcinoma Antigen (SCC) improvement was non-significant (MD = −1.19, 95% CI [−2.61, 0.24], p > 0.001, I2 = 100%). Regarding safety, albumin-bound paclitaxel had markedly lower incidences of diarrhea (RR = 0.49, 95% CI [0.33, 0.72], p = 0.003, I2 = 0%), nausea/vomiting (RR = 0.61, 95% CI [0.46, 0.80], p < 0.001, I2 = 0%), thrombocytopenia (RR = 0.61, 95% CI [0.44, 0.85], p = 0.004, I2 = 22%), and myalgia/arthralgia (RR = 0.45, 95% CI [0.22, 0.94], p = 0.03, I2 = 0%), while neutropenia showed no significant difference (RR = 0.58, 95% CI [0.32, 1.03], p = 0.006, I2 = 0%).ConclusionCompared to paclitaxel, albumin-bound paclitaxel (nab-paclitaxel) demonstrates superior efficacy in the treatment of esophageal cancer, with fewer adverse reactions such as diarrhea, thrombocytopenia, and musculoskeletal pain. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-08-01 |
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| series | Frontiers in Oncology |
| spelling | doaj-art-c585104a982a4d4886df7e95e7b4efe22025-08-20T03:46:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16126781612678Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysisJiayang Song0Yu Xiong1Yu Xiong2Hao Liu3Wei Zhang4Zhongfu Tan5Nanjiang Liu6Department of Pharmacy, Cangxi People’s Hospital, Guangyuan, Sichuan, ChinaDepartment of Pharmacy, Affiliated Hospital of University of Electronic Science and Technology of China Medical School·Mianyang Central Hospital, Mianyang, Sichuan, ChinaNational Health Commission Key Laboratory of Nuclear Technology Medical Transformation, Mianyang, Sichuan, ChinaScience and Technology Department of North Sichuan Medical College, Nanchong, Sichuan, ChinaDepartment of Pharmacy, Kaizhou District People’s Hospital, Kaizhou, Chongqing, ChinaDepartment of Pharmacy, Cangxi People’s Hospital, Guangyuan, Sichuan, ChinaDepartment of Pharmacy, Cangxi People’s Hospital, Guangyuan, Sichuan, ChinaObjectiveTo systematically evaluate the efficacy and safety of albumin-bound paclitaxel and paclitaxel in the treatment of esophageal cancer.MethodsSeven databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, and China Biology Medicine disc) were searched for randomized controlled trials (RCTs) of albumin-bound paclitaxel and paclitaxel in the treatment of esophageal cancer. The search was conducted from database inception to February 2025. Literature quality was assessed using the Cochrane Risk of Bias Tool version 1 (RoB 1), and the systematic review and meta-analysis was performed using RevMan 5.4.1 and STATA18.ResultsEleven RCTs were included. Meta-analysis demonstrated that albumin-bound paclitaxel significantly improved objective response rate [ORR; relative risk (RR) = 1.67, 95% confidence interval (CI) [1.45, 1.92], p < 0.001, I2 = 0%] and disease control rate (DCR; RR = 1.69, 95% CI [1.43, 1.98], p < 0.001, I2 = 0%) compared to paclitaxel. It also showed superior improvements in serum tumor markers: cancer antigen 125 (CA125) [mean difference (MD) = −1.69, 95% CI [−2.73, −0.65], p < 0.001, I2 = 83%], Carbohydrate antigen 19-9 (CA199) (MD = −2.12, 95% CI [−3.39, −0.84], p = 0.001, I2 = 85%), and carcinoembryonic antigen (CEA) (MD = −2.01, 95% CI [−2.53, −1.50], p < 0.001, I2 = 99%), although Squamous Cell Carcinoma Antigen (SCC) improvement was non-significant (MD = −1.19, 95% CI [−2.61, 0.24], p > 0.001, I2 = 100%). Regarding safety, albumin-bound paclitaxel had markedly lower incidences of diarrhea (RR = 0.49, 95% CI [0.33, 0.72], p = 0.003, I2 = 0%), nausea/vomiting (RR = 0.61, 95% CI [0.46, 0.80], p < 0.001, I2 = 0%), thrombocytopenia (RR = 0.61, 95% CI [0.44, 0.85], p = 0.004, I2 = 22%), and myalgia/arthralgia (RR = 0.45, 95% CI [0.22, 0.94], p = 0.03, I2 = 0%), while neutropenia showed no significant difference (RR = 0.58, 95% CI [0.32, 1.03], p = 0.006, I2 = 0%).ConclusionCompared to paclitaxel, albumin-bound paclitaxel (nab-paclitaxel) demonstrates superior efficacy in the treatment of esophageal cancer, with fewer adverse reactions such as diarrhea, thrombocytopenia, and musculoskeletal pain.https://www.frontiersin.org/articles/10.3389/fonc.2025.1612678/fullalbumin-bound paclitaxelpaclitaxelesophageal cancerefficacyadverse reactionssystematic review |
| spellingShingle | Jiayang Song Yu Xiong Yu Xiong Hao Liu Wei Zhang Zhongfu Tan Nanjiang Liu Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis Frontiers in Oncology albumin-bound paclitaxel paclitaxel esophageal cancer efficacy adverse reactions systematic review |
| title | Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis |
| title_full | Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis |
| title_fullStr | Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis |
| title_short | Efficacy of albumin-bound paclitaxel versus paclitaxel in esophageal cancer: a systematic review and meta-analysis |
| title_sort | efficacy of albumin bound paclitaxel versus paclitaxel in esophageal cancer a systematic review and meta analysis |
| topic | albumin-bound paclitaxel paclitaxel esophageal cancer efficacy adverse reactions systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1612678/full |
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