Objective  To carry out the clinical comprehensive evaluation of the safety, effectiveness, economy, innovation, suitability and accessibility of albumin-bound paclitaxel (nab-PTX) in the treatment of metastatic pancreatic cancer and to provide evidence-based reference for drug rational use.

Methods  The comprehensive evaluation index system of nab-PTX was constructed by means of literature reviewed and expert consultation. Based on the constructed clinical comprehensive evaluation index system, the method of rapid health technology assessment (rHTA) was used to evaluate the safety, effectiveness and economy. In terms of innovation, suitability and accessibility evaluation, relevant data such as drug package inserts, authoritative guidelines, drug price data and research data obtained by the National Medical Products Administration were evaluated.

Results  The results of all dimensions showed that in terms of safety, nab-PTX combined gemcitabine (GEM) regimen had a lower incidence of adverse reactions than that of FOLFIRINOX regimen (fluorouracil + leucovorin + irinotecan + oxaliplatin), similar to that of GEM regimen,  and had a higher incidence of neutropenia and thrombocytopenia than S1. In terms of effectiveness, nab-PTX combined GEM regimen could significantly increase ob-jective response rate (ORR) and disease control rate (DCR) compared with GEM and S1 regimen. Compared with FOLFIRINOX regimen, nab-PTX combined GEM regimen showed no significant difference in overall survival, progression-free survival, ORR, DCR and 1-year survival, but significantly reduced the rate of requiring second-line treatment. In terms of economy, nab-PTX combined GEM regimen was more economical than FOLFI-RINOX regimen in the treatment of metastatic pancreatic cancer. What’s more, the nab-PTX combined GEM regimen has no cost-effectiveness advantage, but with the de-velopment of policies and the reduction of the nab-PTX price, the economic advantage of nab-PTX combined GEM regimen will be further reflected. In terms of innovation, nab-PTX was a new structure of nanoparticles formed by combining albumin with paclitaxel, making it more advantageous. In terms of suitability, the compliance of patients with nab-PTX was improved, and the clinical use process also had a good suitability. In terms of accessibility, nab-PTX had a stable price level, good availability and affordability with the reducing price in recent years.

Conclusion  nab-PTX is an innovative structure of paclitaxel, and nab-PTX combined GEM regimen is safe and effective in the treatment of patients with metastatic pancreatic cancer, not inferior to FOLFIRINOX regimen. In addition, nab-PTX is more economical than FOLFIRINOX, and the compliance of patients is improved, the clinical use process has better suitability, and has good availability, affordability and accessibility.

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