Platinum-based chemotherapy in early-stage triple negative breast cancer: A meta-analysis

Saleh, Ramy; Nadler, Michelle; Desnoyers, Alexandra; Meti, Nicholas; Fazelzad, Rouhi; Amir, Eitan

doi:10.1016/j.ctrv.2021.102283

Cited by 16 publications

(11 citation statements)

References 48 publications

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“…Similar to our results, Bian et al (HR 0.70; 95% CI: 0.58 to 0.84) and Saleh et al (HR 0.70; 95%CI 0.56 to 0.89) demonstrated a DFS benefit with the use of platinum agents in early TNBC [ 12 , 31 ]. Both included the RCT by Feng Du et al [ 30 ], which we excluded as it was a non-inferiority RCT.…”

Section: Discussionsupporting

confidence: 91%

“…Our results pertaining to pCR and toxicities are in keeping with published systematic reviews, with platinum increasing pCR as compared to standard at the cost of increased toxicity, especially anaemia and thrombocytopaenia [ [10] , [11] , [12] ].…”

Section: Discussionsupporting

confidence: 88%

“…Prior meta-analyses [ 10 , 11 ] have demonstrated higher pCR rates with the addition of platins in the neoadjuvant setting, but whether this improves survival outcomes is unclear [ 12 , 13 ]. We designed this systematic review to analyse if carboplatin in addition to neoadjuvant or adjuvant therapy in TNBC leads to better DFS and OS in patients compared to standard AT chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis

et al. 2022

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis

et al. 2022

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“…Existing studies have shown that platinum-based chemotherapy drugs combined with taxane-based chemotherapy drugs can synergistically inhibit the proliferation and spread of cancer cells, and at the same time can reduce the systemic toxicity caused by the drugs, cisplatin and carboplatin [ 8 – 10 ]. However, although platinum drugs have strong antitumor activity, their long-term overdose can induce a series of clinical adverse reactions, among which thrombocytopenia is the most common [ 11 , 12 ], Adverse reactions such as myelosuppression are aggravated, so it should be carefully considered when long-term clinical use of this combination chemotherapy regimen is required. Finally, the evaluation indicators of the clinical treatment effect of breast cancer include survival rate, recurrence rate, remission rate, etc.…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have found that the PCR of the PB regimen is higher than that of the PF. scheme [ 13 – 16 ]; on the other hand, the researchers found after a 56.2-month follow-up survey of patients: DFS of PB: PF was RR = 0.75 vs 0.62, P = 0.43; OS of PB: PF was RR = 0.90 vs 1.10, P = 0.58, the DFS of platinum-based therapy was significantly higher than that of platinum-free therapy, while the OS of patients treated with PB and PF was opposite [ 11 , 17 ]. In conclusion, compared with non-platinum drugs, whether platinum-based drug-based therapy is more suitable for the treatment of TNBC patients needs to be further clarified.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of platinum-based and non-platinum-based drugs on triple-negative breast cancer: meta-analysis

et al. 2022

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Background Triple-negative breast cancer (TNBC), the subtype of breast cancer with the highest mortality rate, shows clinical characteristics of high heterogeneity, aggressiveness, easy recurrence, and poor prognosis, which is due to lack of expression of estrogen, progesterone receptor and human epidermal growth factor receptor 2. Currently, neoadjuvant chemotherapy (NAT) is still the major clinical treatment for triple-negative breast cancer. Chemotherapy drugs can be divided into platinum and non-platinum according to the presence of metal platinum ions in the structure. However, which kind is more suitable for treating TNBC remains to be determined. Methods The relevant randomized clinical trials (RCTs) that explore the effectiveness of chemotherapy regimens containing platinum-based drugs (PB) or platinum-free drugs (PF) in treating TNBC patients were retrieved through PubMed, EMBASE, Cochrane Library, CNKI, and other literature platforms, above research findings, were included in the meta-analysis. The incidence of overall remission rate (ORR), pathological complete remission rate (pCR), overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and adverse events (AE) were compared between the two groups. Results In this study, 12 clinical trials with a total of 4580 patients were included in the analysis. First, the ORR in 4 RCTs was, PB vs PF = 52% vs 48% (RR = 1.05, 95% CI: 0.91–1.21, P = 0.48); the pCR in 5 RCTs was, PB vs PF = 48% vs 41% (RR = 1.38, 95% CI: 0.88–2.16, P = 0.17). CI: 0.88–2.16, P = 0.17; the other 2 RCTs reported significantly higher DFS and OS rates in the PB group compared with the PF group, with the combined risk ratio for DFS in the PB group RR = 0.22 (95% CI:0.06–0.82, P = 0.015); the combined risk ratio for DFS in the PF group RR = 0.15 (95% CI. 0.04–0.61, P = 0.008); OS rate: PB vs PF = 0.046 vs 0.003; secondly, 2 RCTs showed that for patients with BRCA-mutated TNBC, the pCR rate in the PB and PF groups was 18% vs 26%, 95% CI: 2.4–4.2 vs 4.1–5.1; meanwhile, the median subject in the PB group The median PFS was 3.1 months (95% CI: 2.4–4.2) in the PB group and 4.4 months (95% CI: 4.1–5.1) in the PC group; finally, the results of the clinical adverse effects analysis showed that platinum-containing chemotherapy regimens significantly increased the incidence of adverse effects such as thrombocytopenia and diarrhea compared with non-platinum regimens, while the incidence of adverse effects such as vomiting, nausea, and neutropenia was reduced. The incidence of adverse reactions was reduced. Conclusion Compared with non-platinum drugs, platinum drugs significantly improved clinical treatment effective indexes, such as PCR, ORR, PFS, DFS, and OS rate in the treatment of TNBC patients without BRCA mutant may cause more serious hematological adverse reactions. Accordingly, platinum-based chemotherapy should be provided for TNBC patients according to the patient's special details.

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Platinum-based chemotherapy for early triple-negative breast cancer

Mason,

Willson,

Egger

et al. 2023

Cochrane Database of Systematic Reviews

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Platinum-based chemotherapy in early-stage triple negative breast cancer: A meta-analysis

Cited by 16 publications

References 48 publications

Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis

Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis

Efficacy of platinum-based and non-platinum-based drugs on triple-negative breast cancer: meta-analysis

Platinum-based chemotherapy for early triple-negative breast cancer

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