SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1612678
Efficacy of Albumin-Bound Paclitaxel versus Paclitaxel in Esophageal Cancer: a systematic review and meta-Analysis
Provisionally accepted
- 1Cangxi People's Hospital, Guangyuan, China
- 2Mianyang Central Hospital, Mianyang, Sichuan Province, China
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Objective To systematically evaluate the efficacy and safety of albumin-bound paclitaxel and paclitaxel in the treatment of esophageal cancer. Methods Seven databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfangdata , China Science and Technology Journal Database, 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.Eleven RCTs were included. Meta-analysis demonstrated that albumin-bound paclitaxel significantly improved objective response rate (ORR: RR = 1.67, 95% CI [1.45, 1.92], P < 0.001, I 2 =0%) and disease control rate (DCR: RR = 1.69, 95% CI [1.43, 1.98], P < 0.001, I 2 =0%) compared to paclitaxel. It also showed superior improvements in serum tumor markers: CA125 (MD = -1.69, 95% CI [-2.73, -0.65], P < 0.001, I 2 =83%), CA199 (MD = -2.12, 95% CI [-3.39, -0.84], P = 0.001, I 2 =85%), and CEA (MD = -2.01, 95% CI [-2.53, -1.50], P < 0.001, I 2 =99%), though SCC improvement was non-significant (MD = -1.19, 95% CI [-2.61, 0.24], P > 0.001, I 2 =100%). Regarding safety, albumin-bound paclitaxel had markedly lower incidences of diarrhea (RR = 0.49, 95% CI [0.33, 0.72], P =0.003, I 2 =0%), nausea/vomiting (RR = 0.61, 95% CI [0.46, 0.80], P<0.001, I 2 =0%), thrombocytopenia (RR = 0.61, 95% CI [0.44, 0.85], P =0.004, I 2 =22%), and myalgia/arthralgia (RR = 0.45, 95% CI [0.22, 0.94], P = 0.03, I 2 =0%), while neutropenia showed no significant difference (RR = 0.58, 95% CI [0.32, 1.03], P= 0.006, I 2 =0%). Conclusion Compared 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.
Keywords: Albumin-bound paclitaxel, Paclitaxel, esophageal cancer, efficacy, Adverse Reactions, Systematic review, Meta-analysis
Received: 29 Apr 2025; Accepted: 24 Jul 2025.
Copyright: © 2025 Song and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu Xiong, Mianyang Central Hospital, Mianyang, 621000, Sichuan Province, China
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