{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:11:06Z","timestamp":1790079066809,"version":"4.0.1"},"reference-count":42,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype with limited targeted treatment options. This systematic review and meta-analysis evaluated pathological complete response (pCR) outcomes associated with nab-paclitaxel-containing neoadjuvant regimens incorporating platinum chemotherapy and\/or immune checkpoint inhibitors in early-stage TNBC. Methods: PubMed\/MEDLINE, Scopus, Google Scholar, CENTRAL, and Embase were searched for eligible publications within the review window (January 2005 through 31 March 2026). Eligible studies were randomized or prospective clinical studies of non-metastatic TNBC receiving nab-paclitaxel-containing neoadjuvant regimens with platinum and\/or immune checkpoint inhibition. Randomized checkpoint-inhibitor comparisons were synthesized as risk ratios; eligible prospective non-randomized pCR datasets were synthesized using a logit random-effects model with REML variance estimation and Hartung-Knapp-Sidik-Jonkman inference. Results: The final evidence base comprised 21 unique eligible prospective studies. Four clinically comparable randomized checkpoint-inhibitor trials (n = 1228) yielded a pooled pCR risk ratio of 1.25 (95% CI 1.12\u20131.41; I2 = 0%). Fourteen prospective non-randomized datasets (n = 539; 320 pCR events) yielded a pooled pCR proportion of 59.8% (HKSJ 95% CI 53.8\u201365.6%; I2 = 32.7%; \u03c42 = 0.0559). Conclusions: Within nab-paclitaxel-containing neoadjuvant backbones, checkpoint-inhibitor addition was associated with higher pCR in randomized comparative evidence. The approximately 60% pooled pCR proportion from prospective non-randomized studies is descriptive and should not be interpreted as a cross-regimen comparison because of clinical and methodological heterogeneity.<\/jats:p>","DOI":"10.3390\/jcm15187321","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:09:35Z","timestamp":1790075375000},"page":"7321","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathological Complete Response to Nab-Paclitaxel\u2013Containing Neoadjuvant Regimens in Early Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1102-9306","authenticated-orcid":false,"given":"Rasha Aziz Attia","family":"Salama","sequence":"first","affiliation":[{"name":"Ras Al Khaimah College of Medicine, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"El-Tanani","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8454-8158","authenticated-orcid":false,"given":"Syed Arman","family":"Rabbani","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6948-3619","authenticated-orcid":false,"given":"Mohamedanas","family":"Patni","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Medicine, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-7125","authenticated-orcid":false,"given":"Bhoomendra","family":"Bhongade","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9456-2033","authenticated-orcid":false,"given":"Rasha","family":"Babiker","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Medicine, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakta Mani","family":"Satyam","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Medicine, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran Rashid","family":"Rangraze","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Medicine, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-2820","authenticated-orcid":false,"given":"Adil Farooq","family":"Wali","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2334-2332","authenticated-orcid":false,"given":"Sirajunisa","family":"Talath","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Eladil","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah College of Medicine, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1038\/nrclinonc.2016.66","article-title":"Triple-negative breast cancer: Challenges and opportunities of a heterogeneous disease","volume":"13","author":"Bianchini","year":"2016","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1056\/NEJMra1001389","article-title":"Triple-negative breast cancer","volume":"363","author":"Foulkes","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1056\/NEJMoa1910549","article-title":"Pembrolizumab for early triple-negative breast cancer","volume":"382","author":"Schmid","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S0140-6736(13)62422-8","article-title":"Pathological complete response and long-term clinical benefit in breast cancer: The CTNeoBC pooled analysis","volume":"384","author":"Cortazar","year":"2014","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1517\/14656566.7.8.1041","article-title":"Albumin-bound paclitaxel: A next-generation taxane","volume":"7","author":"Gradishar","year":"2006","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1158\/1078-0432.CCR-05-1634","article-title":"Increased antitumor activity, intratumor paclitaxel concentrations, and endothelial cell transport of cremophor-free, albumin-bound paclitaxel, ABI-007, compared with cremophor-based paclitaxel","volume":"12","author":"Desai","year":"2006","journal-title":"Clin. Cancer Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1093\/jnci\/djx258","article-title":"Comparison of neoadjuvant Nab-Paclitaxel+Carboplatin vs Nab-Paclitaxel+Gemcitabine in triple-negative breast cancer: Randomized WSG-ADAPT-TN trial results","volume":"110","author":"Gluz","year":"2018","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e382","DOI":"10.1002\/onco.13574","article-title":"Phase II trial of neoadjuvant carboplatin and nab-paclitaxel in patients with triple-negative breast cancer","volume":"26","author":"Yuan","year":"2021","journal-title":"Oncologist"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.clbc.2014.02.005","article-title":"Phase II trial of neoadjuvant weekly nanoparticle albumin-bound paclitaxel, carboplatin, and biweekly bevacizumab therapy in women with clinical stage II or III HER2-negative breast cancer","volume":"14","author":"Layman","year":"2014","journal-title":"Clin. Breast Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1093\/annonc\/mdy127","article-title":"Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: A systematic review and meta-analysis","volume":"29","author":"Poggio","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s40425-016-0165-6","article-title":"Clinical significance of tumor-infiltrating lymphocytes in breast cancer","volume":"4","author":"Stanton","year":"2016","journal-title":"J. Immunother. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S1470-2045(17)30904-X","article-title":"Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: A pooled analysis of 3771 patients treated with neoadjuvant therapy","volume":"19","author":"Denkert","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/S0140-6736(20)31953-X","article-title":"Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): A randomised, double-blind, phase 3 trial","volume":"396","author":"Mittendorf","year":"2020","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1093\/annonc\/mdz158","article-title":"A randomised phase II study investigating durvalumab in addition to an anthracycline taxane-based neoadjuvant therapy in early triple-negative breast cancer: Clinical results and biomarker analysis of GeparNuevo study","volume":"30","author":"Loibl","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.annonc.2022.02.004","article-title":"Pathologic complete response (pCR) to neoadjuvant treatment with or without atezolizumab in triple-negative early high-risk and locally advanced breast cancer: NeoTRIPaPDL1 Michelangelo randomized study","volume":"33","author":"Gianni","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41523-021-00219-7","article-title":"Neoadjuvant durvalumab plus weekly nab-paclitaxel and dose-dense doxorubicin\/cyclophosphamide in triple-negative breast cancer","volume":"7","author":"Foldi","year":"2021","journal-title":"npj Breast Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s10549-023-06929-9","article-title":"A phase II study of neoadjuvant atezolizumab and nab-paclitaxel in patients with anthracycline-resistant early-stage triple-negative breast cancer","volume":"199","author":"Yam","year":"2023","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102700","DOI":"10.1016\/j.eclinm.2024.102700","article-title":"Neoadjuvant anthracycline followed by toripalimab combined with nab-paclitaxel in patients with early triple-negative breast cancer (NeoTENNIS): A single-arm, phase II study","volume":"74","author":"He","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103709","DOI":"10.1016\/j.eclinm.2025.103709","article-title":"Neoadjuvant tislelizumab plus nab-paclitaxel and carboplatin for triple-negative breast cancer: A multicenter, open-label, phase II cTRIO study","volume":"91","author":"Wang","year":"2026","journal-title":"eClinicalMedicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1001\/jama.2024.23560","article-title":"Camrelizumab vs placebo in combination with chemotherapy as neoadjuvant treatment in patients with early or locally advanced triple-negative breast cancer: The CamRelief randomized clinical trial","volume":"333","author":"Chen","year":"2025","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1038\/s41392-025-02337-1","article-title":"Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): Efficacy, safety and biomarker analysis","volume":"10","author":"Liu","year":"2025","journal-title":"Signal Transduct. Target Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_24","first-page":"2127","article-title":"Methodological quality of case series studies: An introduction to the JBI critical appraisal tool","volume":"18","author":"Munn","year":"2020","journal-title":"JBI Evid. Synth."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1038\/s41392-025-02137-7","article-title":"Neoadjuvant apatinib addition to sintilimab and carboplatin-taxane based chemotherapy in patients with early triple-negative breast cancer: The phase 2 NeoSAC trial","volume":"10","author":"Shen","year":"2025","journal-title":"Signal Transduct. Target Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"105869","DOI":"10.1016\/j.esmoop.2025.105869","article-title":"Safety and efficacy of tiragolumab, atezolizumab and chemotherapy for early-stage or PD-L1-positive advanced triple-negative breast cancer: A phase Ib study","volume":"10","author":"Kuemmel","year":"2025","journal-title":"ESMO Open"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.annonc.2020.01.072","article-title":"Pembrolizumab plus chemotherapy as neoadjuvant treatment of high-risk, early-stage triple-negative breast cancer: Results from the phase 1b open-label, multicohort KEYNOTE-173 study","volume":"31","author":"Schmid","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejca.2023.01.001","article-title":"Pembrolizumab in combination with nab-paclitaxel for the treatment of patients with early-stage triple-negative breast cancer\u2014A single-arm phase II trial (NeoImmunoboost, AGO-B-041)","volume":"184","author":"Fasching","year":"2023","journal-title":"Eur. J. Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6654","DOI":"10.1038\/s41467-023-42479-w","article-title":"Neoadjuvant camrelizumab plus nab-paclitaxel and epirubicin in early triple-negative breast cancer: A single-arm phase II trial","volume":"14","author":"Wang","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e91737","DOI":"10.7554\/eLife.91737","article-title":"Effects of neoadjuvant stereotactic body radiotherapy plus adebrelimab and chemotherapy for triple-negative breast cancer: A pilot study","volume":"12","author":"Chen","year":"2023","journal-title":"eLife"},{"key":"ref_31","first-page":"1969","article-title":"Phase II trial of weekly nab-paclitaxel and carboplatin treatment with or without trastuzumab as nonanthracycline neoadjuvant chemotherapy for locally advanced breast cancer","volume":"10","author":"Huang","year":"2015","journal-title":"Int. J. Nanomed."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1097\/JS9.0000000000001011","article-title":"Neoadjuvant camrelizumab plus non-platinum chemotherapy containing nab-paclitaxel in early triple-negative breast cancer: A prospective phase II study (NCT04676997)","volume":"110","author":"Zheng","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1038\/s41392-025-02254-3","article-title":"Efficacy, safety and exploratory analysis of neoadjuvant tislelizumab (a PD-1 inhibitor) plus nab-paclitaxel followed by epirubicin\/cyclophosphamide for triple-negative breast cancer: A phase 2 TREND trial","volume":"10","author":"Zhang","year":"2025","journal-title":"Signal Transduct. Target Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5427","DOI":"10.1158\/0008-5472.CAN-20-1792","article-title":"Association of pathologic complete response with long-term survival outcomes in triple-negative breast cancer: A meta-analysis","volume":"80","author":"Huang","year":"2020","journal-title":"Cancer Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1158\/1078-0432.CCR-19-3492","article-title":"Pathologic complete response after neoadjuvant chemotherapy and impact on breast cancer recurrence and survival: A comprehensive meta-analysis","volume":"26","author":"Spring","year":"2020","journal-title":"Clin. Cancer Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S1470-2045(21)00589-1","article-title":"Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: A multicentre pooled analysis of 5161 patients","volume":"23","author":"Yau","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S1470-2045(14)70160-3","article-title":"Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): A randomised phase 2 trial","volume":"15","author":"Schneeweiss","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.annonc.2022.01.009","article-title":"Long-term efficacy and safety of addition of carboplatin with or without veliparib to standard neoadjuvant chemotherapy in triple-negative breast cancer: 4-year follow-up data from BrighTNess, a randomized phase III trial","volume":"33","author":"Geyer","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/S1470-2045(15)00542-2","article-title":"Nab-paclitaxel versus solvent-based paclitaxel in neoadjuvant chemotherapy for early breast cancer (GeparSepto\u2014GBG 69): A randomised, phase 3 trial","volume":"17","author":"Untch","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1056\/NEJMoa2112651","article-title":"Event-free survival with pembrolizumab in early triple-negative breast cancer","volume":"386","author":"Schmid","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1001\/jamaoncol.2024.3456","article-title":"Neoadjuvant immune checkpoint inhibitors plus chemotherapy in early breast cancer: A systematic review and meta-analysis","volume":"10","author":"Villacampa","year":"2024","journal-title":"JAMA Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1056\/NEJMoa2409932","article-title":"Overall survival with pembrolizumab in early-stage triple-negative breast cancer","volume":"391","author":"Schmid","year":"2024","journal-title":"N. Engl. J. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7321\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:35:18Z","timestamp":1790076918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":42,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187321"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187321","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}