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Review
. 2023 Jun 15;15(6):4279-4290.
eCollection 2023.

A meta-analysis of the incidence and risk of skin toxicity with nab-paclitaxel and paclitaxel in cancer treatment

Hong-Bo Li  1 , Wen-Hui Wang  2 , Zhi-Yong Wang  2
Affiliations
Review

A meta-analysis of the incidence and risk of skin toxicity with nab-paclitaxel and paclitaxel in cancer treatment

Hong-Bo Li et al. Am J Transl Res. .

Abstract

Background: Skin toxicity of varying severity occurs mostly during various courses of chemotherapy. In clinical trials and practice, we have found that both nab-paclitaxel and paclitaxel cause side effects such as rash and pruritus. To further clarify the incidence of rash and pruritus in both, we conducted the present study by a systematic evaluation, the results of which can be used to guide clinical dosing choices.

Methods: An electrical search was performed on randomized controlled research trials of nab-paclitaxel and paclitaxel for the treatment of malignancies. The necessary data were extracted, integrated, and analyzed from the included studies by systematic evaluation and meta-analysis, depending on the study design. Further subgroup analyses were performed to explore the incidence of rash and pruritus in nab-paclitaxel and paclitaxel.

Results: Eleven studies with a total of 971 patients with malignancy were included. Four studies were application of single-agent nab-paclitaxel compared with paclitaxel, and seven studies were comparative chemotherapy drug combinations. The incidence of rash was higher in all grades of nab-paclitaxel than that in paclitaxel (OR=1.39, CI 95% [1.18-1.62]); the incidence of rash was higher in lower grades of paclitaxel than that in solvent-based paclitaxel (OR=1.31, CI 95% [1.11-1.53]); the incidence of rash was higher in all grades in the single-agent application comparison. The incidence of rash was higher in nab-paclitaxel than that in paclitaxel (OR=1.81, CI 95% [1.26-2.59]); there was no significant difference in the incidence of pruritus between nab-paclitaxel and paclitaxel (OR=1.19, CI 95% [0.88-1.61]).

Conclusion: In comparison with paclitaxel, nab-paclitaxel significantly increased the risk of a teething rash. There was a significant risk correlation between nab-paclitaxel and teething rash. Early prevention, identification, and treatment of rash could significantly improve patient's quality of life and optimize their clinical survival.

Keywords: META analysis; Paclitaxel; nab-paclitaxel; pruritus; rash.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Flow chart of the literature search and selection process in the meta-analysis.
Figure 2
Figure 2
Overall rash incidence results (11 studies).
Figure 3
Figure 3
Risk of bias of included trials summary.
Figure 4
Figure 4
Risk of bias of included trials graph.
Figure 5
Figure 5
The funnel plot showed that there was high publication bias.
Figure 6
Figure 6
Overall rash incidence results (10 studies).
Figure 7
Figure 7
The funnel plot showed that there was low publication bias.
Figure 8
Figure 8
Odds ratio of Nab-paclitaxel to paclitaxel in the treatment of low-grade rash.
Figure 9
Figure 9
The funnel plot showed that there was low publication bias.
Figure 10
Figure 10
Odds ratio of Nab-paclitaxel to paclitaxel in the treatment of single-agent rash.
Figure 11
Figure 11
The funnel plot showed that there was low publication bias.
Figure 12
Figure 12
Odds ratio of Nab-paclitaxel to paclitaxel in the treatment of pruritus.
Figure 13
Figure 13
The funnel plot showed that there was low publication bias.
See this image and copyright information in PMC

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