Objective To investigate the clinical effect of nanoparticle albumin-bound paclitaxel ( nab-paclitaxel) combined with gemcitabine in the treatment of advanced pancreatic cancer, and to provide a basis for making better clinical decisions. Methods CBM, CNKI, Wanfang Data, VIP, PubMed, Embase, Cochrane Library, and Web of Science were searched for Chinese and English articles published up to October 2018, with English keywords of“pancreatic cancer”, “gemcitabine”, “nab-paclitaxel”, and “abraxane”and Chinese keywords of“pancreatic cancer”, “gemcitabine”, and“nanoparticle albumin-bound paclitaxel” ( in Chinese) . Appropriate clinical trials were screened out according to the inclusion and exclusion criteria. Then, the data were extracted and quality assessment was performed. RevMan 5. 3 software was used to perform the meta-analysis. Results A total of 10 clinical trials were included, with a total of2908 patients. There were 1633 patients in the study group ( treated with nab-paclitaxel combined with gemcitabine) and 1275 patients in the control group ( treated with FOLFIRINOX) . The results of the meta-analysis showed that compared with the control group, the study group had significantly lower incidence rates of drug side-effects such as fatigue ( odds ratio [OR]= 0. 61, 95% confidence interval [CI]:0. 46-0. 80, P = 0. 0005) , diarrhea ( OR = 0. 39, 95% CI: 0. 29-0. 54, P < 0. 001) , nausea and vomiting ( OR = 0. 46, 95% CI: 0. 26-0. 84, P = 0. 01) , and grade 3-4 neutropenia ( OR = 0. 61, 95% CI: 0. 43-0. 88, P = 0. 007) , as well as a significantly lower rate of second-line treatment ( OR = 0. 30, 95% CI: 0. 14-0. 63, P = 0. 001) . There were no significant differences between the two groups in disease remission rate ( OR = 0. 82, 95% CI: 0. 45-1. 51, P = 0. 53) , disease control rate ( OR = 0. 97, 95% CI: 0. 48-1. 97, P =0. 93) , 1-year survival rate ( OR = 0. 80, 95% CI: 0. 63-1. 01, P = 0. 06) , and incidence rate of complications after neoadjuvant chemotherapy ( OR = 1. 84, 95% CI: 0. 33-10. 19, P = 0. 49) . Conclusion Nab-paclitaxel combined with gemcitabine can improve the clinical outcome of advanced pancreatic cancer without increasing drug adverse events, and therefore, it has good safety and efficacy in clinical practice.
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