Nab-paclitaxel plus platinum versus paclitaxel plus platinum as first-line therapy in patients with metastatic or recurrent cervical cancer

Abstract Purpose This study aimed to assess the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) plus platinum versus paclitaxel plus platinum as first-line therapy in patients with metastatic or recurrent cervical cancer. Methods Between October 2020 and March 2022, consecutive patients with diagnosed with metastatic or recurrent cervical cancer were retrospectively recruited in our hospital. Fifty-four patients were treated with nab-paclitaxel plus cisplatin or carboplatin. Twenty-four patients were treated with paclitaxel plus cisplatin or carboplatin. The two groups were compared for objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety. Univariate Cox proportional hazards regression was used to identify the prognostic factors for survival in patients with cervical cancer. Results The nab-paclitaxel group showed a higher ORR (72.2% vs 45.8%; P=0.025) than the paclitaxel group. The median PFS was significantly longer in the nab-paclitaxel group than in the paclitaxel group (12 vs 7 months; P=0.041). The median OS was not reached in the nab-paclitaxel group and 15 months in the paclitaxel group, with no statistical difference (P=0.077). The univariate analysis showed that distant organ metastasis and poor ORR were associated with worse PFS and OS (P<0.05). The most common toxicity was hematological adverse events, including grade 3-4 neutropenia, grade 3 anemia and thrombocytopenia in both groups and no statistical differences were observed between the groups (all P>0.05). Conclusion Compared with paclitaxel plus platinum, nab-paclitaxel plus platinum may be an effective and tolerable option as first-line therapy for patients with metastatic or recurrent cervical cancer.