Efficacy and Safety of Nab-Paclitaxel and Its Correlation With SPARC Expression in Ovarian Cancer

Objective  To compare the efficacy and safety of nab-paclitaxel versus other paclitaxel formulations in the treatment of ovarian cancer, and to explore the correlation between the efficacy of nab-paclitaxel and SPARC protein expression.

Methods  A total of 48 patients with ovarian cancer treated between January 2018 and December 2024 were enrolled and assigned to a nab-paclitaxel group (n=32) or a non-nab-paclitaxel group (n=16).Treatment efficacy and adverse reactions were assessed. SPARC protein expression in tumor tissues was detected and analyzed in the nab-paclitaxel group.

Results  Baseline characteristics were balanced between the two groups (all P > 0.05). The objective response rate (ORR) was significantly higher in the nab-paclitaxel group (87.5%, 28/32) compared to the other-paclitaxel group (56.3%, 9/16) (P=0.039). The disease control rate (DCR) was 96.9% versus 87.5%, respectively, with no significant difference (P=0.527). Survival analysis showed median progression-free survival (PFS) of 25.0 months 95% confidence interval(CI) 12.4–37.6 and median overall survival (OS) of 54.0 months (95%CI 31.9–76.2) for the nab-paclitaxel group, compared to 19.0 months (95%CI 13.2–24.6) and 44.0 months (95%CI 23.7–64.3) for the other-paclitaxel group, with no statistically significant differences in PFS or OS (P=0.12 and P=0.46, respectively). No significant differences were observed in the incidence of hematologic toxicity, gastrointestinal reactions, neurotoxicity, or hepatic/renal dysfunction between the groups (all P > 0.05). Among 25 patients in the nab-paclitaxel group evaluated for SPARC expression, the positive rate was 60.0% (15/25). The ORR was significantly higher in the SPARC-positive subgroup (100%, 15/15) compared to the SPARC-negative subgroup (60.0%, 6/10) (P=0.017). DCR was 100% versus 90%, and median PFS was 25.0 versus 20.0 months, respectively, with no significant differences (all P > 0.05). Correlation analysis indicated a positive association between SPARC expression and ORR (r=0.535, P=0.006), and a weak, non-significant positive correlation with DCR (r=0.250, P=0.228).

Conclusions  Nab-paclitaxel demonstrates a significantly higher ORR compared to other paclitaxel formulations in treating ovarian cancer, with comparable survival outcomes and safety profile. The positive correlation between treatment efficacy and SPARC protein expression suggests SPARC as a potential predictive biomarker for nab-paclitaxel response.