Platinum‐based chemotherapy in advanced triple‐negative breast cancer: A multicenter real‐world study in China

Abstract

Platinum-based chemotherapy (PBC) has proven benefits in phase III studies for advanced triple-negative breast cancer (TNBC) patients; however, real-world data of large samples from multiple centers are lacking. Our study was to compare the effectiveness of PBC and non-PBC in advanced TNBC patients in multicenter real-world settings. Totally, 495 patients with advanced TNBC receiving PBC (n = 350) or non-PBC (n = 145) at four cancer centers in China between 2003 and 2019 were included. Treatment responses and outcomes were compared between the two groups from first-line to third-line treatment. Of patients with PBC, 249 (71.1%) received PBC from first-line chemotherapy, 86 (24.6%) from second-line and 15 (4.3%) from third-line treatment. In first-line treatment, PBC was superior to non-PBC in objective response rate (ORR, 53.0% vs 32.1%, P < .001) and median progression-free survival (PFS, 8.4 vs 6.0 months, P = .022), whereas overall survival (OS) was similar (19.2 vs 16.8 months, P = .439). When comparing patients receiving non-PBC doublets (n = 221) with those receiving PBC doublets (n = 249), the same trend was observed in ORR (32.6% vs 53.0%, P < .001), median first-line PFS (6.5 vs 8.4 months, P = .041) and median first-line OS(17.8 vs 19.2 months, P = .568). Paclitaxel/docetaxel + platinum was more likely to be used, followed by gemcitabine + platinum. In second/third-line treatment, PBC yielded a similar response and survival compared to non-PBC. Adding PBC in the first-line therapy was better than that in the latter-line of treatment in terms of ORR, PFS and OS (P < .001). Toxic effects of PBC were tolerable and the most common adverse event was neutropenia (38.6%). PBC doublets exhibited superior efficacy and manageable toxicity compared to non-PBC doublets in the first-line treatment for Chinese mTNBC patients.

Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials

“…In a recent multicenter real-world study in China, the authors retrospectively analyzed the medical records of 495 patients with advanced TNBC and observed that first-line platinum-based chemotherapy was superior to platinum-free chemotherapy with regard to ORRs (53.0% vs. 32.1%, P < 0.001) and the median PFS (8.4 months vs. 6.0 months, P ¼ 0.022); however, OS rates was similar (19.2 months vs. 16.8 months, P ¼ 0.439). 37 These results were consistent with our findings which observed longer PFS but no significant difference in OS in patients who received platinum-based chemotherapy.…”

Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials

“…In a recent multicenter real-world study in China, the authors retrospectively analyzed the medical records of 495 patients with advanced TNBC and observed that first-line platinum-based chemotherapy was superior to platinum-free chemotherapy with regard to ORRs (53.0% vs. 32.1%, P < 0.001) and the median PFS (8.4 months vs. 6.0 months, P ¼ 0.022); however, OS rates was similar (19.2 months vs. 16.8 months, P ¼ 0.439). 37 These results were consistent with our findings which observed longer PFS but no significant difference in OS in patients who received platinum-based chemotherapy.…”

A prospective, open-label, multicenter phase IV clinical trial on the safety and efficacy of lobaplatin-based chemotherapy in advanced breast cancer

“…For TNBC, the most aggressive subtype, previous studies showed an ORR of 26.7–56.6% and median PFS of 4.3–8.4 months with platinum-based chemotherapy. 19 , 21 – 24 The ORR (36.5%) and median PFS (4.6 months) with LBP-based chemotherapy in our study were within the range of these previous results of platinum-based chemotherapy in patients with TNBC. 19 , 21 – 24 Taken the safety and efficacy results together, LBP could be a good option when platinum-based chemotherapy was selected for the treatment of advanced breast cancer.…”

“…19,[21][22][23][24] The ORR (36.5%) and median PFS (4.6 months) with LBP-based chemotherapy in our study were within the range of these previous results of platinum-based chemotherapy in patients with TNBC. 19,[21][22][23][24] Taken the safety and efficacy results together, LBP could be a good option when platinum-based chemotherapy was selected for the treatment of advanced breast cancer.…”

Survival benefit of platinum-based regimen in early stage triple negative breast cancer: A meta-analysis of randomized controlled trials

“…A latest meta-analysis of randomized controlled clinical trials (RCTs) from Cochrane library in 2020 indicated that Pt-containing regimens might improve time to progression or progression-free survival (TTP/PFS) of metastatic TNBC (mTNBC) patients, and provide a small benefit to overall survival (OS) 11 . These data, along with other real-world studies 12 , support the role of Pt in the first-line salvage chemotherapy for mTNBC.…”

Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials

“…In a recent multicenter real-world study in China, the authors retrospectively analyzed the medical records of 495 patients with advanced TNBC and observed that first-line platinum-based chemotherapy was superior to platinum-free chemotherapy with regard to ORRs (53.0% vs. 32.1%, P < 0.001) and the median PFS (8.4 months vs. 6.0 months, P ¼ 0.022); however, OS rates was similar (19.2 months vs. 16.8 months, P ¼ 0.439). 37 These results were consistent with our findings which observed longer PFS but no significant difference in OS in patients who received platinum-based chemotherapy.…”

A prospective, open-label, multicenter phase IV clinical trial on the safety and efficacy of lobaplatin-based chemotherapy in advanced breast cancer

“…For TNBC, the most aggressive subtype, previous studies showed an ORR of 26.7–56.6% and median PFS of 4.3–8.4 months with platinum-based chemotherapy. 19 , 21 – 24 The ORR (36.5%) and median PFS (4.6 months) with LBP-based chemotherapy in our study were within the range of these previous results of platinum-based chemotherapy in patients with TNBC. 19 , 21 – 24 Taken the safety and efficacy results together, LBP could be a good option when platinum-based chemotherapy was selected for the treatment of advanced breast cancer.…”

“…19,[21][22][23][24] The ORR (36.5%) and median PFS (4.6 months) with LBP-based chemotherapy in our study were within the range of these previous results of platinum-based chemotherapy in patients with TNBC. 19,[21][22][23][24] Taken the safety and efficacy results together, LBP could be a good option when platinum-based chemotherapy was selected for the treatment of advanced breast cancer.…”

Survival benefit of platinum-based regimen in early stage triple negative breast cancer: A meta-analysis of randomized controlled trials

“…A latest meta-analysis of randomized controlled clinical trials (RCTs) from Cochrane library in 2020 indicated that Pt-containing regimens might improve time to progression or progression-free survival (TTP/PFS) of metastatic TNBC (mTNBC) patients, and provide a small benefit to overall survival (OS) 11 . These data, along with other real-world studies 12 , support the role of Pt in the first-line salvage chemotherapy for mTNBC.…”

Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials

“…In a recent multicenter real-world study in China, the authors retrospectively analyzed the medical records of 495 patients with advanced TNBC and observed that first-line platinum-based chemotherapy was superior to platinum-free chemotherapy with regard to ORRs (53.0% vs. 32.1%, P < 0.001) and the median PFS (8.4 months vs. 6.0 months, P ¼ 0.022); however, OS rates was similar (19.2 months vs. 16.8 months, P ¼ 0.439). 37 These results were consistent with our findings which observed longer PFS but no significant difference in OS in patients who received platinum-based chemotherapy.…”

A prospective, open-label, multicenter phase IV clinical trial on the safety and efficacy of lobaplatin-based chemotherapy in advanced breast cancer

“…For TNBC, the most aggressive subtype, previous studies showed an ORR of 26.7–56.6% and median PFS of 4.3–8.4 months with platinum-based chemotherapy. 19 , 21 – 24 The ORR (36.5%) and median PFS (4.6 months) with LBP-based chemotherapy in our study were within the range of these previous results of platinum-based chemotherapy in patients with TNBC. 19 , 21 – 24 Taken the safety and efficacy results together, LBP could be a good option when platinum-based chemotherapy was selected for the treatment of advanced breast cancer.…”

“…19,[21][22][23][24] The ORR (36.5%) and median PFS (4.6 months) with LBP-based chemotherapy in our study were within the range of these previous results of platinum-based chemotherapy in patients with TNBC. 19,[21][22][23][24] Taken the safety and efficacy results together, LBP could be a good option when platinum-based chemotherapy was selected for the treatment of advanced breast cancer.…”

Survival benefit of platinum-based regimen in early stage triple negative breast cancer: A meta-analysis of randomized controlled trials

“…A latest meta-analysis of randomized controlled clinical trials (RCTs) from Cochrane library in 2020 indicated that Pt-containing regimens might improve time to progression or progression-free survival (TTP/PFS) of metastatic TNBC (mTNBC) patients, and provide a small benefit to overall survival (OS) 11 . These data, along with other real-world studies 12 , support the role of Pt in the first-line salvage chemotherapy for mTNBC.…”