PMID- 36335316
OWN - NLM
STAT- MEDLINE
DCOM- 20221110
LR  - 20221110
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Nov 5
TI  - Combined atezolizumab and nab-paclitaxel in the treatment of triple negative 
      breast cancer: a meta-analysis on their efficacy and safety.
PG  - 1139
LID - 10.1186/s12885-022-10225-y [doi]
LID - 1139
AB  - BACKGROUND: Triple negative breast cancer (TNBC) is clinically aggressive breast 
      cancer with a poor prognosis. Approximately 20% of TNBC has been found to express 
      programmed death ligand 1 (PD-L1), making it a potential therapeutic target. As a 
      PD-L1 inhibitor, atezolizumab is a recently approved immunotherapeutic drug for 
      TNBC, this meta-analysis (MA) was aimed to review the randomized controlled trial 
      studies (RCTs) of combined atezolizumab and nab-paclitaxel in the treatment of 
      TNBC and synthesize the evidence-based results on its effectiveness and safety. 
      METHOD: We searched PubMed, Embase, EBSCOhost and ClinicalTrials.gov for the 
      eligible RCTs which compared the efficacy and safety of combined atezolizumab and 
      nab-paclitaxel with nab-paclitaxel alone. The outcomes analyzed included overall 
      survival (OS), progression-free survival (PFS), objective response rate (ORR) and 
      treatment-related adverse effects (AEs). RESULTS: A total of six RCTs were 
      included in this MA. For efficacy, although OS was not significantly prolonged 
      with combined atezolizumab and nab-paclitaxel (HR 0.90, 95% CI [0.79, 1.01], 
      p=0.08), this combination therapy significantly improved PFS (HR 0.72, 95% CI 
      [0.59, 0.87], p=0.0006) and ORR (RR 1.25, 95% CI [0.79, 1.01] p<0.00001). For 
      safety, any AEs, haematological, gastrointestinal, and liver AEs showed no 
      statistically significant differences between the atezolizumab and nab-paclitaxel 
      combination group and nab-paclitaxel alone group. However, serious AEs, high 
      grade, dermatological, pulmonary, endocrine, and neurological AEs were 
      significantly lower with nab-paclitaxel alone compared to atezolizumab and 
      nab-paclitaxel combined (p-value range from <0.00001 to 0,02). CONCLUSION: 
      Atezolizumab combined with nab-paclitaxel was associated with improved outcomes 
      in the treatment of TNBC; however, this combination resulted in more toxicity 
      compared to nab-paclitaxel alone. While nab-paclitaxel alone produced 
      chemotherapy-related AEs, the combination of atezolizumab with nab-paclitaxel 
      produced AEs, especially immune-related AEs such as haematological, pulmonary, 
      endocrine, and neurological AEs. TRIAL REGISTRATION: This research work of 
      systematic review has been registered on PROSPERO (Registration number: 
      CRD42022297952).
CI  - (c) 2022. The Author(s).
FAU - Sharmni Vishnu, K
AU  - Sharmni Vishnu K
AD  - BMed Science, School of Medicine, International Medical University, 126, Jalan 
      Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
AD  - Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, 
      5005, Australia.
FAU - Win, Thin Thin
AU  - Win TT
AUID- ORCID: 0000-0002-6468-5761
AD  - Pathology Department, School of Medicine, International Medical University, 126, 
      Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia. 
      thinthinwin@imu.edu.my.
FAU - Aye, Saint Nway
AU  - Aye SN
AD  - Pathology Department, School of Medicine, International Medical University, 126, 
      Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
FAU - Basavaraj, Arun Kumar
AU  - Basavaraj AK
AD  - Pathology Department, School of Medicine, International Medical University, 126, 
      Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20221105
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 0 (130-nm albumin-bound paclitaxel)
RN  - 0 (Albumins)
RN  - 52CMI0WC3Y (atezolizumab)
RN  - P88XT4IS4D (Paclitaxel)
SB  - IM
MH  - Humans
MH  - Albumins/therapeutic use
MH  - *Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - Paclitaxel/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - *Triple Negative Breast Neoplasms/drug therapy
PMC - PMC9637314
OTO - NOTNLM
OT  - Atezolizumab
OT  - PD-L1 inhibitor
OT  - Triple negative breast cancer
OT  - and meta-analysis
OT  - systematic review
COIS- The authors declare that they have no competing interests.
EDAT- 2022/11/06 06:00
MHDA- 2022/11/09 06:00
PMCR- 2022/11/05
CRDT- 2022/11/06 00:52
PHST- 2022/06/20 00:00 [received]
PHST- 2022/10/17 00:00 [accepted]
PHST- 2022/11/06 00:52 [entrez]
PHST- 2022/11/06 06:00 [pubmed]
PHST- 2022/11/09 06:00 [medline]
PHST- 2022/11/05 00:00 [pmc-release]
AID - 10.1186/s12885-022-10225-y [pii]
AID - 10225 [pii]
AID - 10.1186/s12885-022-10225-y [doi]
PST - epublish
SO  - BMC Cancer. 2022 Nov 5;22(1):1139. doi: 10.1186/s12885-022-10225-y.