Seven RCTs (1,694 participants) were included in the review. All seven RCTs scored 3 out of a possible 5 on the Jadad scale.
There was no statistically significant difference in overall survival between paclitaxel-based and docetaxel-based regimens (five RCTs) but there was significant heterogeneity for this result (Ι²=81.3%). In a subgroup analysis of studies in which patients received taxane-based regimens as first line therapy, the paclitaxel-based regimen significantly improved overall survival compared with the docetaxel-based regimen (HR 0.73, 95% CI 0.56 to 0.94, Ι²=0%; two RCTs).
There was no statistically significant difference in progression-free survival (two RCTs) or time to progression (three RCTs) between paclitaxel-based and docetaxel-based regimens but there was significant heterogeneity for these results (Ι²=65% and Ι²=74.2%).
There was no statistically significant difference in overall response rate between paclitaxel-based and docetaxel-based regimens (seven RCTs) with no evidence of significant heterogeneity.
Grade 3 or 4 haematological toxicities, mucositis, diarrhoea and fatigue were statistically significantly more common with the docetaxel-based regimen. Incidence of Grade 3 or 4 nausea and peripheral neuropathy was not statistically significantly different between the two treatment groups. There was significant heterogeneity for most of these results.
There was no evidence of significant publication bias.