Efficacy and safety of nab-paclitaxel in advanced or recurrent small cell lung cancer: a single-arm meta-analysis

Background Although various effective agents used as second- and third-line treatments for advanced or recurrent small cell lung cancer have improved overall survival, the optimal therapeutic regimen remains controversial. Previous studies have shown that albumin-bound paclitaxel exhibits favorable anticancer activity in many cancer types. However, almost all studies of albumin-bound paclitaxel for recurrent small cell lung cancer are non-randomized controlled trials with small sample sizes, diverse first-line treatment regimens, and non-controlled data analyses. This may result in a lack of valid indicators for evaluating the efficacy and safety of albumin-bound paclitaxel. Therefore, this meta-analysis aims to assess the efficacy and safety of albumin-bound paclitaxel in patients with advanced or recurrent small cell lung cancer. Methods PubMed, Embase, the Cochrane Library, and Web of Science databases were systematically searched for relevant studies. Outcomes including overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were extracted for further analysis. Results Nine studies involving 334 patients were enrolled in this meta-analysis. In terms of tumor response, the pooled ORR and DCR were 25.0% and 62.5%, respectively. With regard to survival analysis, the pooled PFS and OS were 3.16 months and 7.23 months, respectively. The most common treatment-related adverse events of nab-paclitaxel were Leukopenia (all grade: 59.3%, ≥grade III: 14.1%), Neutropenia (all grade: 54.9%, ≥grade III: 14.7%), and Anemia (all grade: 53.0%, ≥grade III: 6.2%). Subgroup analysis revealed that combination therapy with immunotherapy was associated with numerically higher response rates and survival. Conclusions In summary, this meta-analysis demonstrated that albumin-bound paclitaxel has moderate efficacy and manageable safety in the later-line treatment of advanced or recurrent small cell lung cancer. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261350933 , identifier 420261350933.