Four RCTs were included with 2,207 patients (range 272 to 751).
A significant difference favouring taxane-based doublet over single-agent taxane chemotherapy was found for progression-free survival (RR 1.33, 95% CI 1.02 to 1.75; four trials with five intervention arms, the control arm of one trial was counted twice) and partial response (RR 1.43, 95% CI 1.10 to 1.86; two trials); the progression-free survival analysis was subject to significant statistical heterogeneity.
There were no statistically significant differences between chemotherapy regimens for overall response rate (four trials), one-year survival rate (two trials), clinical benefit (two trials), and complete response (two trials). Significant statistical heterogeneity was found for the overall response rate and complete response analyses.
Rates of (grade 3 and 4) neutropenia, nausea, fatigue, and alopecia did not differ significantly, but rates of stomatitis (RR 5.42, 95% CI 3.21 to 9.14; four trials) and diarrhoea (RR 2.51, 95% CI 1.53 to 4.12; four trials) were significantly higher with taxane-based doublet chemotherapy. Significant statistical heterogeneity was found for the neutropenia, fatigue, and alopecia analyses.