Weekly carboplatin plus neoadjuvant anthracycline-taxane-based regimen in early triple-negative breast cancer: a prospective phase II trial by the Breast Cancer Task Force of the Belgian Society of Medical Oncology (BSMO)

Fontaine, Christel; Renard, Vincent; Bulk, Heidi Van den; Vuylsteke, Peter; Glorieux, Philippe; Dopchie, Catherine; Decoster, Lore; Vanacker, Leen; Azambuja, Evandro de; Grève, Jacques De; Awada, Ahmad; Wildiers, Hans

doi:10.1007/s10549-019-05259-z

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…Despite efficiency in salvage and neoadjuvant therapy of TNBC, the survival benefits of Pt-based regimens in eTNBC remain unclear 17 . Some retrospective or single-armed studies indicated that long term survival of eTNBC in Pt-based groups was non-inferior to standard A&T-based regimens 8 , 17 – 19 . However, results from properly designed RCTs were inadequate.…”

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

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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.

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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

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“…Holanek et al [ 29 ] reported 85.5% of DFS after 3 years of follow-up in patients treated with carboplatin, compared with 76.1% of patients who did not receive carboplatin. Fontaine et al [ 26 ] reported EFS an OS as secondary endpoints. From a total of 63 patients, 9 patients relapsed.…”

Section: Resultsmentioning

confidence: 99%

“…The most widely accepted definition of pCR is the absence of residual invasive disease in the breast and sampled axillary nodes (ypT0/is, ypN0). Residual Cancer Burden (RCB) was scored for all patients using the Symmans criteria [ 26 ]. Patients who had pCR (RCB 0) were included; near pCR (RCB I) cases were not included in this study.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of different neoadjuvant treatment regimens in BRCA-mutated triple negative breast cancer: a systematic review and meta-analysis

Caramelo¹,

Silva

Caramelo

et al. 2022

Hered Cancer Clin Pract

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Purpose Triple negative breast cancer (TNBC) is an aggressive breast cancer strongly associated with BRCA mutation. Standard neoadjuvant chemotherapy remains the standard of care for early stage TNBC, the optimal chemotherapy regimen is still a matter of discussion. Other agents, such as poly-ADP-ribosyl polymerase inhibitors (PARPi) and anti-vascular endothelial growth factor (VEGF) antibodies were evaluated in the neoadjuvant setting. This systematic review and meta-analysis intend to evaluate the impact of neoadjuvant treatments in pCR rates in TNBC gBRCA mutation, beyond traditional standard chemotherapy. Methods PubMed, Clinicaltrials.gov, Cochrane CENTRAL, Embase and key oncological meetings for trials were searched for studies reporting neoadjuvant chemo-immunotherapy in BRCA positive TNBC. Results Out of 1238 records reviewed, thirty-one trials were included, resulting in a total 619 BRCA-mutated TNBC patients. In BRCA mutated TNBC patients who received cisplatin in monotherapy the proportion of patients who achieved pCR was 0.53 (95%CI [0.30, 0.76]), and when treatment combined standard chemotherapy and platin derivatives the proportion of pCR increased to 0.62 (95% CI [0.48, 0.76]). The group of patients treated with platin derivatives, anthracyclines ± taxanes achieved the highest proportion of pCR, 0.66. Patients treated with PARPi alone show a pCR proportion of 0.55 (95% CI [0.30, 0.81]); and when standard chemotherapy and platin derivatives were combined with PARPi the proportion of pCR did not vary. Conclusions Patients with BRCA mutated TNBC treated with cisplatin in monotherapy demonstrate inferior proportion in the pCR achievement when compared with standard chemotherapy plus platin derivates. The best pCR was achieved with platin derivates in association with anthracyclines ± taxanes. No difference in pCR was found between PARPi alone vs PARPi with standard chemotherapy.

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“…After screening the title and abstract, there are only 39 publications were left for full-text review. After excluding 17 publications based on full-text analysis, 22 studies [ 8 , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] ] remained for qualitative and quantitative analysis, containing 18% (392/2158) of patients with a BRCA1/2 mutation. To further understand the significance of BRCA1/2 , 22 trials were separated into three phases: neoadjuvant, adjuvant, and progressed.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of BRCA1/2 mutation for predicting the effect of platinum-based chemotherapy in triple-negative breast cancer

Jia

Wang

et al. 2022

The Breast

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Weekly carboplatin plus neoadjuvant anthracycline-taxane-based regimen in early triple-negative breast cancer: a prospective phase II trial by the Breast Cancer Task Force of the Belgian Society of Medical Oncology (BSMO)

Cited by 10 publications

References 23 publications

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

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

Efficacy of different neoadjuvant treatment regimens in BRCA-mutated triple negative breast cancer: a systematic review and meta-analysis

A systematic review and meta-analysis of BRCA1/2 mutation for predicting the effect of platinum-based chemotherapy in triple-negative breast cancer

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