@article{TCR120219,
author = {Xiao Li and Yaqiong Song and Jianhua Li},
title = {Efficacy of nab-paclitaxel combined with immune checkpoint inhibitors in solid tumors: a systematic review and meta-analysis of randomized controlled trials},
journal = {Translational Cancer Research},
volume = {15},
number = {7},
year = {2026},
keywords = {},
abstract = {Background: Nab-paclitaxel combined with immune checkpoint inhibitors (ICIs) is a promising strategy across solid tumors, but its overall efficacy across cancer types and treatment settings remains to be comprehensively quantified. We therefore aimed to evaluate the efficacy of nab-paclitaxel plus ICIs versus nab-paclitaxel-based regimens without immunotherapy across multiple solid tumor types and treatment settings.Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched through January 1, 2026, for randomized controlled trials (RCTs) comparing nab-paclitaxel plus ICIs with nab-paclitaxel-based therapy without ICIs. Primary outcomes were overall survival (OS), progression-free survival (PFS), and pathological complete response (pCR). Secondary outcomes included objective response rate (ORR) and disease control rate (DCR). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed by cancer type and ICI class.Results: Twenty-four RCTs enrolling 6,682 patients across five tumor types [non-small cell lung cancer (NSCLC), triple-negative breast cancer (TNBC), pancreatic ductal adenocarcinoma (PDAC), gastric cancer, and esophageal squamous cell carcinoma (ESCC)] were included. Nab-paclitaxel plus ICIs significantly improved OS (HR =0.79; 95% CI: 0.73–0.84), PFS (HR =0.63; 95% CI: 0.58–0.69), and pCR (RR =1.28; 95% CI: 1.15–1.43) compared with controls. ORR (RR =1.33; 95% CI: 1.20–1.47) and DCR (RR =1.15; 95% CI: 1.02–1.29) were also improved. Subgroup analyses showed consistent OS benefits across all cancer types (P=0.70) and ICI classes. Anti-programmed cell death protein 1 (PD-1) agents showed significantly greater PFS benefit than anti-programmed death-ligand 1 (PD-L1) agents (P=0.02). Sensitivity analyses confirmed robustness of all estimates.Conclusions: Nab-paclitaxel combined with ICIs significantly improves survival, tumor response, and pCR across multiple solid tumors. These findings support the broad applicability of this combination and highlight the value of anti-PD-1-based regimens in optimizing PFS.},
issn = {2219-6803}, url = {https://tcr.amegroups.org/article/view/120219}
}