Meta-analysis nixes platinum-based therapy for metastatic triple-negative breast cancer

  • Pandy JGP & al.
  • BMC Cancer
  • 8 Nov 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A meta-analysis finds that platinum-based therapy (e.g., carboplatin, cisplatin) is not effective for metastatic triple-negative breast cancer (mTNBC), but it is effective as neoadjuvant therapy for early TNBC (eTNBC).

Why this matters

  • Findings suggest that treatment guidelines should be revised to include platinum-based therapy for eTNBC, but not for mTNBC.
  • More randomized controlled trials (RCTs) are needed of mTNBC.

Study design

  • Meta-analysis of 11 RCTs (n=2946) after search of PubMed, Embase, Cochrane, clinical trials databases, and hand search.
  • Funding: None.

Key results

  • In the neoadjuvant setting, platinum-based therapy displayed higher pathologic complete response (pCR; 40.1% vs 27.7% for nonplatinum-based therapy; OR, 1.75; 95% CI, 1.36-2.26; I2=40%).
    • Subgroup analysis of combination platinum-based therapy plus taxane was even more effective for pCR (44.6% vs 27.8% for nonplatinum-based therapy plus taxane; OR, 2.10; 95% CI, 1.48-2.97).
  • In the metastatic setting, based on 3 RCTs (n=531), platinum-based therapy failed to display PFS benefit (HR, 1.16; 95% CI, 0.90-1.49).

Limitations

  • Small number of RCTs, participants, especially for mTNBC.