Efficacy and safety of nano-paclitaxel formulation for cancer treatment: evidence from randomized clinical trials.

Aim: We aimed to analyze efficacy and adverse events for nano-bound paclitaxel in cancer treatment, which remain controversial. Method: We obtained relevant previously published studies and extracted data on the efficacy and adverse events of nano-bound paclitaxel. Fifteen randomized clinical trials were included. Results: Nanoparticle albumin-bound (Nab-) paclitaxel was beneficial in terms of objective response rate (odds ratio [OR]: 1.08, 95% CI: 0.72-1.62) and partial response (OR: 1.28, 95% CI: 0.89-1.83), while polymeric micellar (PM-) paclitaxel was beneficial in terms of objective response rate (OR: 1.76) and partial disease (hazard ratio [HR]: 0.65). Both Nab-paclitaxel and PM-paclitaxel resulted in slightly longer overall survival (HR: 0.93 and 0.94) and progression-free survival (HR: 0.93 and 0.87) when compared with solvent-based paclitaxel. Peripheral sensory neuropathy (OR: 3.47), neutropenia (OR: 1.79) and anemia (OR: 1.79) were more frequent after Nab-paclitaxel treatment. Conclusion: Nano-paclitaxel formulations have a better efficacy in cancer treatment; however, they increase the risk of hematological adverse events and peripheral sensory neuropathy. The PM-paclitaxel treatment had a high safety effect.