Li Zhen-Yu, Zhang Zhen, Cao Xiao-Zhong, Feng Yun, Ren Sha-Sha
Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China.
J Int Med Res. 2020 Oct;48(10):300060520964340. doi: 10.1177/0300060520964340.
Triple-negative breast cancer (TNBC) is associated with higher aggressiveness and mortality than hormone-positive breast cancer because of the lack of approved therapeutic targets. Patients with TNBC who attain a pathological complete response (pCR) after neoadjuvant chemotherapy have improved survival. Platinum-based agents show promising activity in TNBC; however, their use remains controversial. We conducted a meta-analysis to assess the role of platinum-based agents in neoadjuvant chemotherapy in patients with TNBC.
We performed an extensive literature search of the Pubmed, Embase, and Cochrane databases. We calculated pooled odds ratios (OR) with 95% confidence intervals (CI) for the identified studies.
Eight randomized controlled trials with 1345 patients were included in the analysis. The addition of platinum-based agents improved pCR compared with neoadjuvant therapy based on anthracyclines, cyclophosphamide, taxanes, and fluorouracil (49.1% vs. 35.9%; OR: 1.87, 95% CI: 1.23-2.86). Hematological adverse events were similar in both groups, except for more thrombocytopenia in the platinum-based group (OR: 7.96, 95% CI: 3.18-19.93).
The addition of platinum-based agents to neoadjuvant chemotherapy improved pCR rates in patients with TNBC, with a slight increase in hematological toxicities. Platinum-based agents might thus be an accessible and economically viable option in patients with TNBC.
三阴性乳腺癌（TNBC）因缺乏经批准的治疗靶点，与激素阳性乳腺癌相比具有更高的侵袭性和死亡率。新辅助化疗后达到病理完全缓解（pCR）的TNBC患者生存率有所提高。铂类药物在TNBC中显示出有前景的活性；然而，其使用仍存在争议。我们进行了一项荟萃分析，以评估铂类药物在TNBC患者新辅助化疗中的作用。
我们对PubMed、Embase和Cochrane数据库进行了广泛的文献检索。我们为纳入的研究计算了合并比值比（OR）及95%置信区间（CI）。
分析纳入了八项随机对照试验，共1345例患者。与基于蒽环类、环磷酰胺、紫杉烷和氟尿嘧啶的新辅助治疗相比，添加铂类药物提高了pCR率（49.1%对35.9%；OR：1.87，95%CI：1.23 - 2.86）。两组血液学不良事件相似，但铂类药物组血小板减少症更多（OR：7.96，95%CI：3.18 - 19.93）。
在TNBC患者的新辅助化疗中添加铂类药物可提高pCR率，血液学毒性略有增加。因此，铂类药物可能是TNBC患者可获得且经济可行的选择。
