Department of Medical Oncology.
Department of Pathology.
Ann Oncol. 2011 Apr;22(4):848-856. doi: 10.1093/annonc/mdq461. Epub 2010 Oct 5.
Although recent experimental data strongly suggest that platinum-based chemotherapy (PBCT) could improve the outcome of triple-negative breast cancer (TNBC), clinical data are lacking. Here, the authors reviewed clinical outcome in patients with metastatic TNBC treated with PBCT.
We conducted a retrospective analysis of all patients (N=143) treated for metastatic breast cancer with PBCT between 2000 and 2008, at Institut Curie, Paris, France. Ninety-three of them (63.7%) had TNBC. One-hundred twenty patients received cisplatin (CDDP). The main combination used was CDDP-ifosfamide, in 101 patients (70.2%).
Median follow-up was 44 months. For the overall population (N=143), median overall survival (OS) and median progression-free survival (PFS) were 11 and 5 months, respectively. Objective response rate was 33.3% in the TNBC group versus 22% in non-TNBC, P=0.1. We observed no difference of OS, PFS and response duration. Other prognostic factors for poor OS were visceral metastasis sites (P<0.001). One patient died from sepsis during aplasia, 15 had to switch from CDDP to carboplatin because of CDDP-related toxicity.
Metastatic TNBC patients treated with PBCT tended to have a higher response rate, without a significant improvement of PFS or OS, compared with other subtypes. Toxicity was acceptable. Longer observation and further analysis are warranted.
尽管最近的实验数据强烈表明铂类化疗（PBCT）可以改善三阴性乳腺癌（TNBC）的预后，但临床数据仍存在不足。在此，作者回顾了接受 PBCT 治疗的转移性 TNBC 患者的临床结局。
我们对法国巴黎居里研究所 2000 年至 2008 年间接受 PBCT 治疗转移性乳腺癌的所有患者（N=143）进行了回顾性分析。其中 93 例（63.7%）为 TNBC。120 例患者接受顺铂（CDDP）治疗。主要联合用药为 CDDP-异环磷酰胺，有 101 例（70.2%）。
中位随访时间为 44 个月。在总体人群（N=143）中，中位总生存期（OS）和中位无进展生存期（PFS）分别为 11 个月和 5 个月。TNBC 组的客观缓解率为 33.3%，而非 TNBC 组为 22%，P=0.1。我们未观察到 OS、PFS 和缓解持续时间的差异。OS 不良的其他预后因素为内脏转移部位（P<0.001）。1 例患者在骨髓抑制期死于败血症，15 例患者因 CDDP 相关毒性而不得不从 CDDP 转为卡铂。
与其他亚型相比，接受 PBCT 治疗的转移性 TNBC 患者的反应率较高，但 PFS 或 OS 无显著改善。毒性可接受。需要进一步观察和分析。
