Platinum-containing regimens for triple-negative metastatic breast cancer

Egger, Sam; Chan, Matthew Ming Ki; Luo, Qingwei; Wilcken, Nicholas

doi:10.1002/14651858.cd013750

Cited by 19 publications

(21 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to previous studies, the most common AEs associated with platinum regimens are nausea, vomiting, anorexia, anemia, and thrombocytopenia, and the most frequently reported AEs associated with chidamide are fatigue thrombocytopenia, neutropenia, nausea, anorexia, vomiting, and diarrhea (6,16). The most frequent AEs reported in the current study were gastrointestinal events, including nausea (93%) and vomiting (53%), anorexia (53%), constipation (53%), hematological events, including leucopenia (73%), neutropenia (60%), anemia (87%), and thrombocytopenia (53%), and fatigue (60%).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, patients with BRCA1/2 deficient tumors are sensitive to platinum salt treatments. A recent meta-analysis showed that platinum regimens improved progress-free survival (PFS)/time to progression (TTP) in metastatic TNBC (3,5,6). Unfortunately, not all patients benefit from platinum salts, and some develop drug resistance, leading to disease progression or recurrence.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Phase II study of chidamide in combination with cisplatin in patients with metastatic triple-negative breast cancer

Meng¹,

Jin²,

Gong³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

Background: Platinum-based regimens are the mainstay treatments for advanced triple-negative breast cancer (TNBC). Preclinical studies have shown that the histone deacetylase (HDAC) inhibitor chidamide induced antitumor effects in TNBC, and chidamide plus chemotherapy was shown to be tolerable in several malignancies. This study sought to investigate the efficacy and safety of a combination treatment of chidamide and cisplatin in metastatic TNBC patients.Methods: In this phase II, single-arm study, women with metastatic TNBC were administered chidamide (20 mg twice weekly for 2 weeks on a 21-day cycle) and cisplatin (75 mg/m 2 on a 21-day cycle). The primary endpoint was the objective response rate (ORR) by RECIST 1.1. The severity of adverse events was measured by the CTCAE 4.03.Results: Sixteen patients were enrolled in this study. Of these, 15 were available for evaluation. In these 15 patients, confirmed objective responses were seen in 4 patients [26.67%, 95% confidence interval (CI): 10.9%, 51.95%]. The ORRs did not meet the predefined criteria (of a response by at least 5 of the 15 patients); thus, the study remained at stage I. The median progression-free survival (PFS) was 9.8 weeks; 4 patients had a PFS of >25 weeks. In relation to the treatment-related AEs ≥ grade 3, >2 patients had neutropenia (33%), thrombocytopenia (20%), leucopenia (20%), and vomiting (20%).Conclusions: The addition of chidamide did not improve the efficacy of cisplatin in the first-line treatment against advanced TNBC; thus, the phase II clinical trial did not progress any further. Our study appears to be the first to investigate the HDAC inhibitor in TNBC patients and showed disappointing results, which should inform future studies. Future research on cisplatin-based combination treatments for TNBC should consider selecting patients based on predictive biomarkers to increase the clinical benefits.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Phase II study of chidamide in combination with cisplatin in patients with metastatic triple-negative breast cancer

Meng¹,

Jin²,

Gong³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

show abstract

“…Since TNBC has been reported to harbor more proportion (>50%) of homologous DNA recombination defects, either due to BRCA mutation or other mechanisms, it’s supposed that TNBC might be more sensitive to Pt agents 8 – 10 . 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.…”

Section: Introductionmentioning

confidence: 99%

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

Bian

Wen

et al. 2021

npj Breast Cancer

View full text Add to dashboard Cite

Platinum (Pt)-based chemo-regimens have been proved effective in neoadjuvant and salvage chemotherapy of triple negative breast cancer (TNBC). However, the survival benefit of Pt-based regimens in early stage TNBC(eTNBC) treatment has remained unclear. We conducted a meta-analysis to explore its role in improving the clinical outcomes of eTNBC. We carried out a comprehensive literature search on 15 March 2021 for randomized controlled trials (RCTs) comparing ajuvant/neoadjuvant Pt-based and Pt-free chemo-regimens in eTNBC patients, according to PRISMA 2020. We extracted the survival data and utilized the STATA software to calculate the summarized hazard ratios (HRs) and 95% confidence interval (95% CI) for overall survival (OS) and disease-free survival (DFS). Seven eligible RCTs enrolling a total of 2,027 eTNBC patients were identified in this meta-analysis, with 1,007 receiving Pt-free regimens, and the other 1,020 patients receiving Pt-based regimens, respectively. Patients in Pt-based regimens arm were associated with significant improved DFS (HR = 0.70, 95% CI: 0.58–0.84), and OS (HR = 0.78, 95% CI: 0.61–1.00). The survival benefits of DFS remained consistent in both the two strategies of Pt usage, either adding Pt to standard anthracyclines&taxanes based regimens (A&T + Pt), or combination of Pt and taxanes alone (TPt). The survival benefits also remained consistent in either neoadjuvant or adjuvant use of Pt. The present meta-analysis of RCTs revealed that Pt-based chemo-regimens could significantly improve both DFS and OS for eTNBC patients. Based on efficiency and toxicity, we recommend Pt-based regimens for eTNBC, especially the “A&T + Pt” mode if the toxicities are tolerable, which may lead TNBC therapy into a new era.

show abstract

“… 16 Compared with non platinum containing chemotherapy, Platinum-based CT significantly increased ORR (OR = 2.34, 95% CI: 1.66–3.28) in patients with metastatic TNBC 17 and slightly improved OS and PFS in patients with metastatic TNBC. 18 Compared with patients with non TNBC, the PCR rate of patients with TNBC was significantly better after NACT (OR = 2.89, 95% CI: 1.28–6.53). There was no significant difference in PFS between patients with advanced or metastatic TNBC and non TNBC after platinum therapy.…”

Section: Resultsmentioning

confidence: 91%

Treatment for Triple-Negative Breast Cancer: An Umbrella Review of Meta-Analyses

Yin¹,

Zhu²,

Wang³

et al. 2022

IJGM

View full text Add to dashboard Cite

Purpose In recent years, many meta-analyses of triple-negative breast cancer (TNBC) treatment have been published; however, these studies still lack systematic summary. Therefore, the aim of this study is to summarize and evaluate the evidence level and efficacy of treatment for TNBC. Materials and Methods Retrospective and prospective studies on treatment of TNBC were searched in the PubMed, Embase, and Cochrane Library databases. The literature search deadline was June 30, 2021. Two investigators independently screened the literature and extracted the data. In addition, the joint World Health Organization–United Nations Food and Agriculture Organization expert consultation was used to evaluate the validity of the evidence. Results A total of 28 meta-analyses were included in this study. The treatment interventions for TNBC mainly included surgery, chemotherapy (CT), radiotherapy, molecular targeted therapy, immunotherapy, zoledronic acid, and gonadotropin-releasing hormone (GnRH) analog. Platinum improves the pathological complete response (PCR) rate of patients treated with neoadjuvant chemotherapy (NACT), the objective remission rate (ORR) and overall survival (OS) in patients with metastatic triple-negative breast cancer. Capecitabine improves disease-free survival (DFS) and OS in patients treated with adjuvant CT. Bevacizumab was added to NACT to improve the PCR rate in patients. Immunotherapy improves the PCR rate in patients treated with NACT. The improvement in PCR rate in patients with high Ki67 expression treated with neoadjuvant therapy is highly suggestive. Other interventions had suggestive or weak evidence. Conclusion Among the strategies for treating TNBC, platinum, bevacizumab, and immunotherapy can lead to better PCR rates as part of a NACT regimen. Capecitabine as adjuvant CT and platinum in the treatment of metastatic TNBC can benefit patients’ survival. However, the effectiveness of other interventions for TNBC is not yet clear. Further research is needed in the future to obtain more reliable clinical evidence.

show abstract

Platinum-containing regimens for triple-negative metastatic breast cancer

Cited by 19 publications

References 41 publications

Phase II study of chidamide in combination with cisplatin in patients with metastatic triple-negative breast cancer

Phase II study of chidamide in combination with cisplatin in patients with metastatic triple-negative breast cancer

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

Treatment for Triple-Negative Breast Cancer: An Umbrella Review of Meta-Analyses

Contact Info

Product

Resources

About