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Platinumbased chemotherapy in triplenegative breast cancer: A metaanalysis

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Triplenegative breast cancer (TNBC) tumors do not express estrogen, progesterone or HER2/neureceptors. There are no specific treatment guidelines for TNBC patients, however, it has been postulated that their phenotypic and molecular similarity to BRCA1associated cancers would confer sensitivity to certain cytotoxic agents, including platinum. The aim of this metaanalysis was to evaluate the clinical outcome of breast cancer patients treated with platinumbased chemotherapy who had TNBC compared with those with nonTNBC. Electronic (MEDLINE, EMBASE and Cochrane Library databases) and manual searches were conducted throughout December 2011 to identify trials evaluating the use of platinumbased chemotherapy for patients with breast cancer. The methodological quality was assessed in accordance with the QUOROM statement. Seven studies met the eligibility criteria, with a total of 717 patients. Of these patients, 225 were TNBC patients (31%), 492 were nonTNBC patients (69%), 275 received platinumbased neoadjuvant chemotherapy and 442 had advanced/metastatic breast cancers. The results showed that during neoadjuvant chemotherapy, the clinical complete response (cCR) rate and the pathological complete response (pCR) rates were significantly higher for the TNBC group compared with the nonTNBC group (OR, 2.68; 95% CI, 1.696.57; P=0.03 and OR, 2.89; 95% CI, 1.28, 6.53; P=0.01, respectively). However, in advanced/metastatic breast cancers, the cCR, partial response (PR) and the disease control rates for the TNBC group were not significantly different compared with the nonTNBC group. The 6-month progressionfree survival (PFS) rate for the TNBC group was higher than that of the nonTNBC group in all patients (OR, 1.81; 95% CI, 1.112.96; P=0.02). However, the 1 and 2year PFS rates were not significantly different (OR, 1.42; 95% CI, 0.692.92; P=0.35 and OR, 1.11; 95% CI, 0.353.52; P=0.85, respectively). Furthermore, the PFS rates were not significantly different between the groups in patients with advanced/metastatic breast cancer. In conclusion, platinumbased chemotherapy in the breast cancer patients with TNBC showed an improved shortterm efficacy compared with the nonTNBC group during neoadjuvant chemotherapy, but has not yet been demonstrated to have an improved effect in advanced breast cancer.
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Document Type: Research Article

Affiliations: Breast Surgery Department of Tumor Hospital, Guangxi Medical University, Nanning, Gaungxi 530021, P.R. China

Publication date: January 1, 2013

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  • Oncology Letters is a monthly, peer-reviewed journal, available in print and online, that focuses on all aspects of clinical oncology, as well as in vitro and in vivo experimental model systems relevant to the mechanisms of disease.

    The principal aim of Oncology Letters is to provide the prompt publication of original studies of high quality that pertain to clinical oncology, chemotherapy, oncogenes, carcinogenesis, metastasis, epidemiology and viral oncology in the form of original research, reviews and case reports.
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