Efficacy and safety of nanoparticle albumin-bound paclitaxel in elderly patients with metastatic breast cancer: A meta-analysis

Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is an approved treatment for metastatic breast cancer (MBC). However, there is an ongoing debate about the efficacy and safety of nab-paclitaxel in elderly patients. We conducted a meta-analysis to evaluate nab-paclitaxel efficacy and adverse events in MBC patients 65 years and older, compared with MBC patients younger than 65 years (control group). We performed a literature search using PubMed, the Cochrane Library, and EMBASE, from their inception to 30 September 2019. The relevant studies compared overall response rates (ORRs) and incidence of adverse events; four studies comprising 1204 patients were identified and included. ORRs were similar in patients older than 65 years and controls (odds ratio (OR) 0.71, 95% confidence interval (CI) 0.42–1.21). On subgroup analysis, both first-line therapy (OR 2.54, 95% CI 1.92–3.36) and lower Eastern Cooperative Oncology Group (ECOG) performance status (OR 0.20, 95% CI 0.06–0.69) were associated with a higher ORR. Adverse events including neutropenia, sensory neuropathy, diarrhea, and nausea were comparable between the groups. In conclusion, nab-paclitaxel showed comparable efficacy and safety in older and younger patients with MBC. Nab-paclitaxel can be a first-line treatment option for MBC patients 65 years and older.