Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: a systematic review and meta-analysis

Poggio, F.; Bruzzone, Marco; Ceppi, Marcello; Pondé, Noam; Valle, Giovanni La; Mastro, Lucia Del; Azambuja, Evandro de; Lambertini, Matteo

doi:10.1093/annonc/mdy127

Cited by 338 publications

(301 citation statements)

References 43 publications

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“…TNBC patients may show distinct sensitivity to different chemotherapeutic agents. For instance, a recent meta‐analysis reported significant pCR rates increase of platinum‐based neoadjuvant chemotherapy for TNBC while in our study, Baselga et al, Carey et al, and O'Shaughnessy et al used cisplatin or carboplatin as a regimen. Finally, although Bayesian network meta‐analysis is a potential solution enabling indirect comparison when a head‐to‐head trial is not available and making it realizable to rank several treatments by combining direct and indirect comparisons, it only pools the ratios rather than differences between treatments in each study.…”

Section: Discussionmentioning

confidence: 48%

A Bayesian network meta‐analysis of the efficacy of targeted therapies and chemotherapy for treatment of triple‐negative breast cancer

et al. 2018

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Triple‐negative breast cancer (TNBC) is a heterogeneous disease with poorer prognosis than other subtypes, yet effective therapies are still not available. We aimed to compare the efficacy of various targeted therapies with chemotherapy (CT) in TNBC patients using a network meta‐analysis. A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library. A total of 27 randomized controlled trials (RCTs), involving 6924 TNBC patients, were included. Olaparib significantly improved PFS (0.43, 0.29‐0.64) and ORR (2.57, 1.31‐5.09) in comparison with CT. As for bevacizumab + CT, it showed a significant improvement of PFS (0.66, 0.55‐0.80) and ORR (2.15, 1.16‐4.05) compared with CT + placebo. It was also superior to CT alone in PFS (0.48, 0.35‐0.65) and pCR (1.30, 1.13‐1.49 for breast and axillary nodes and 1.26, 1.11‐1.44 for breast). Other targeted agents like iniparib, sorafenib, cetuximab, and ipatasertib combined with CT showed significant superiority in PFS compared with CT alone, and the HRs were 0.75 (0.62‐0.90), 0.44 (0.21‐0.91), 0.67 (0.47‐0.96), and 0.44 (0.24‐0.81), respectively, while some other agents such as sunitinib and cetuximab had the lowest SUCRA in OS, PFS, or ORR without any benefits. In conclusion, our results indicated that the addition of bevacizumab to CT was beneficial for TNBC patients, and olaparib had a great effect in PFS and ORR, especially for those with BRCA mutations. When combined with CT, targeted agents including iniparib, sorafenib, cetuximab, and ipatasertib may have better efficacies for treating TNBC.

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Section: Discussionmentioning

confidence: 48%

A Bayesian network meta‐analysis of the efficacy of targeted therapies and chemotherapy for treatment of triple‐negative breast cancer

et al. 2018

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“…This may include the addition of agents such as platinum compounds, Pertuzumab, Cyclin‐D Kinase 4/6 Inhibitors, and immune checkpoint inhibitors. In a recent meta‐analysis, the addition of a platinum agent in triple negative breast cancer was shown to improve pCR rates though at the expense of higher toxicity . The role of adjuvant systemic treatment after NACT and definitive surgery in patients who do not achieve pCR is also emerging.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent meta-analysis, the addition of a platinum agent in triple negative breast cancer was shown to improve pCR rates though at the expense of higher toxicity. 29 The role of adjuvant systemic treatment after NACT and definitive surgery in patients who do not achieve pCR is also emerging. The recently published CREATE-X and KATHERINE studies reported disease free survival improvements when additional adjuvant systemic treatment is applied to patients with residual disease in the triple negative and HER2 positive breast cancer subgroups.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy in non‐metastatic breast cancer: a study on practice trends in a regional cancer treatment service

Ang

Wewala

Carroll

et al. 2020

Internal Medicine Journal

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Background Neoadjuvant chemotherapy (NACT) is increasingly used for managing locally advanced and high risk non‐metastatic breast cancer. Aims To describe trends in NACT use, assess compliance to best practice recommendations and determine treatment response rates in a regional cancer treatment service. Methods In this retrospective cross‐ sectional study, electronic records of patients who underwent NACT in centres covered by the MidCentral Regional Cancer Treatment Service in 2013 and 2017 were reviewed. Data pertaining to patient demographics, disease status, compliance to best practice recommendations and treatment outcomes were extracted and analysed. Results Of a total of 502 referrals for non‐metastatic breast cancer, 34 underwent NACT with the estimated NACT rate rising from 3.85% (2013) to 9.92% (2017). Compliance to practice recommendations improved in all domains (pre‐treatment tumour and axillary evaluation, marker placement, multidisciplinary discussion). Overall, NACT was well tolerated with only three patients experiencing treatment limiting toxicity. Response rates mirror published data (complete response: 29.4%, partial: 61.8%) with higher responses registered in HER2 positive and triple negative subtypes. Discordance between radiological and pathological response was 28%, with imaging overestimating response in five out of seven cases. Of the 11 (32%) patients who initially underwent breast conserving surgery, six required a second surgery. Conclusion NACT is increasingly used in the Regional Cancer Treatment Service, with improving compliance to practice recommendations. These results are reassuring and can be used to help patients develop a realistic expectation towards NACT.

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“…Poggio et al recently provided a metanalysis including five neoadjuvant randomized trials to evaluate the role of platinumcontaining NACT regimens (GEICAM/2006-03, GeparSixto GBG66, CALGB 40,603 Alliance, UMIN000003355 and BrighTNess) and confirmed the increased probability of obtaining a pCR, compared to platinum-free regimens (54.2% vs 37.1% OR 2.04; 95% CI 1.39-3.00) [6][7][8][9][10][11]. Long-term outcomes results were only reported in two of these studies.…”

Section: The Unselected Tnbc Population: Looking For the Pearl In Thementioning

confidence: 97%

Hype or hope? The strange case of platinum salts’ renaissance in breast cancer

Corvaja

Garutti

Gerratana

et al. 2019

Expert Review of Anticancer Therapy

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Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: a systematic review and meta-analysis

Abstract: CRD42018080042.

Cited by 338 publications

References 43 publications

A Bayesian network meta‐analysis of the efficacy of targeted therapies and chemotherapy for treatment of triple‐negative breast cancer

A Bayesian network meta‐analysis of the efficacy of targeted therapies and chemotherapy for treatment of triple‐negative breast cancer

Neoadjuvant chemotherapy in non‐metastatic breast cancer: a study on practice trends in a regional cancer treatment service

Hype or hope? The strange case of platinum salts’ renaissance in breast cancer

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