Nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy of breast cancer: a systematic review and meta-analysis

Abstract

BackgroundThe value of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in neoadjuvant systemic therapy for breast cancer remains uncertain.MethodsBoth electronic databases and proceedings of oncologic meetings were included in systematic literature search. Pooled rates of pathological complete response (pCR), odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect model to determine the effect of neoadjuvant nab-paclitaxel.ResultsTwenty-one studies with 2357 patients were included, 3 of which were randomized clinical trials. The aggregate pCR(ypT0/is ypN0) rate was 32% (95% CI 25-38%) in unselected breast cancer patients and variated in different subtypes. Within randomized clinical trials, the probability of achieving pCR was significantly higher in the nab-paclitaxel group than in the conventional taxanes group (OR = 1.383, 95%CI 1.141-1.676, p = 0.001). For non-hematological toxic effect, any grade and grade 3-4 peripheral sensory neuropathy occurred more frequently with nab-paclitaxel compared to paclitaxel (any grade, OR = 2.090, 95%CI 1.016-4.302, p = 0.045; grade3-4, OR = 3.766, 95%CI 2.324-6.100, p < 0.001). Hypersensitivity was more common with paclitaxel than nab-paclitaxel at any grade and grade 3-4.Conclusionnab-paclitaxel is an effective cytotoxic drug in neoadjuvant treatment of breast cancer, especially for aggressive tumors in terms of pCR. Exchange of nab-paclitaxel for conventional taxanes could significantly improve pCR rate with reasonable toxicities.

Cyanine based Nanoprobes for Cancer Theranostics

“…Protein NPs are optimal candidates for delivery of therapeutic agents because of biodegradable nature, biocompatibility, non‐immunogenicity and functionalization capability . Since approval of Abraxane (albumin based drug delivery vehicle containing PTX as an anticancer drug) in 2005 by FDA, there is increased concern for fabrication of similar proteins based nanocarriers in cancer treatment . In a specific example to cyanines, protein conjugation is reported to improve the photophysical properties that are essential in increasing therapeutic efficiency.…”

Development of biocompatible and VEGF-targeted paclitaxel nanodrugs on albumin and graphene oxide dual-carrier for photothermal-triggered drug delivery in vitro and in vivo

“…[36][37][38][39] Compared with these carriers, serum albumin as an endogenous protein with good biocompatibility, non-toxicity, and non-immunogenicity has become one of the most exciting carriers to deliver insoluble anticancer drugs. [40][41][42] Moreover, the presence of functional carboxylic and amino groups on the surface facilitates surface functionalization for albumin nanoparticles such as conjugation of targeting moieties. However, the release of drugs in albumin nanoparticles cannot be controlled, which is unfavorable for efficient tumor therapy.…”

The theranostic efficiency of tumor-specific, pH-responsive, peptide-modified, liposome-containing paclitaxel and superparamagnetic iron oxide nanoparticles

“…PTX, one of the most successful anticancer drugs in clinical use, exhibits high antitumor activity against a wide range of tumors, including breast cancer. 33 Here, we selected PTX as the therapeutic drug to prepare the theranostic PTX/ SPIO-SSL-H 7 K(R 2 ) 2 . The antitumor activity of PTX/SPIO-SSL-H 7 K(R 2 ) 2 on human breast carcinoma MDA-MB-231 was confirmed in vitro and in vivo.…”