Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials
Background: Triple-negative breast cancer constitutes approximately 12%-17% of all breast cancer cases, and >33% of patients develop distant metastases. Systemic cytotoxic chemotherapy is the primary treatment for patients with metastatic triple-negative breast cancer; however, the role of first-...
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doaj-6c7429b3cc4046dc83a7c5fd781a20822021-05-13T03:33:27ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382021-05-012010.1177/15330338211016369Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled TrialsFei Lu MS0Yu Hou MS1Zhengting Chen PhD2Jie Jiang PhD3Xi He BS4Yaoxiong Xia MS5Ke Cao MS6Li Chang PhD7Wenhui Li PhD8 Department of Oncology and Hematology, Southern Central Hospital of Yunnan Province, Mengzi, Yunnan, China Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, , Kunming, Yunnan, China Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, , Kunming, Yunnan, China Department of Medical Imagine, , Kunming, Yunnan, China Department of Pediatrics, Southern Central Hospital of Yunnan Province, Mengzi, Yunnan, China Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, , Kunming, Yunnan, China Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, , Kunming, Yunnan, China Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, , Kunming, Yunnan, China Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, , Kunming, Yunnan, ChinaBackground: Triple-negative breast cancer constitutes approximately 12%-17% of all breast cancer cases, and >33% of patients develop distant metastases. Systemic cytotoxic chemotherapy is the primary treatment for patients with metastatic triple-negative breast cancer; however, the role of first-line platinum-based chemotherapy in these patients remains controversial. This meta-analysis evaluated the efficacy and safety of platinum-based first-line chemotherapy for patients with metastatic triple-negative breast cancer. Methods: We systematically searched the PubMed, Embase, Cochrane, and Clinical Trials registry databases up to June 1, 2020 to identify randomized controlled trials that investigated platinum-based vs. first-line platinum-free chemotherapy in patients with metastatic triple-negative breast cancer. We used fixed and random effects models to calculate pooled hazard ratios and odds ratios with 95% confidence intervals for progression-free and overall survival, objective response rates, and grade 3 and 4 adverse events. Results: Four randomized controlled trials ( N = 590 patients) were included. Platinum-based chemotherapy significantly increased the objective response rates from 43.1% to 62.7% (odds ratio 2.34, 95% confidence interval 1.66-3.28, P < 0.001). Three randomized controlled trials ( N = 414 patients) reported survival outcomes. Patients administered platinum-based regimens showed significantly longer progression-free survival (hazard ratio 0.55, 95% confidence interval 0.37-0.82, P = 0.004) and a nonsignificant trend toward improved overall survival (hazard ratio 0.76, 95% confidence interval 0.57-1.00, P = 0.05). Only 2 studies reported the rates of grade 3 and 4 adverse events; grade 3-4 thrombocytopenia was more commonly associated with platinum-based chemotherapy (odds ratio 7.54, 95% confidence interval 1.37-41.60, P = 0.02) and grade 3-4 fatigue with platinum-free chemotherapy (odds ratio 0.23, 95% confidence interval 0.08-0.68, P = 0.008). Conclusions: First-line platinum-based chemotherapy was associated with significantly increased objective response rates, longer progression-free survival, and a nonsignificant trend toward improved overall survival in patients with metastatic triple-negative breast cancer at the high risk of grade 3-4 thrombocytopenia.https://doi.org/10.1177/15330338211016369 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fei Lu MS Yu Hou MS Zhengting Chen PhD Jie Jiang PhD Xi He BS Yaoxiong Xia MS Ke Cao MS Li Chang PhD Wenhui Li PhD |
spellingShingle |
Fei Lu MS Yu Hou MS Zhengting Chen PhD Jie Jiang PhD Xi He BS Yaoxiong Xia MS Ke Cao MS Li Chang PhD Wenhui Li PhD Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials Technology in Cancer Research & Treatment |
author_facet |
Fei Lu MS Yu Hou MS Zhengting Chen PhD Jie Jiang PhD Xi He BS Yaoxiong Xia MS Ke Cao MS Li Chang PhD Wenhui Li PhD |
author_sort |
Fei Lu MS |
title |
Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials |
title_short |
Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials |
title_full |
Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials |
title_fullStr |
Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials |
title_full_unstemmed |
Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials |
title_sort |
efficacy and safety of platinum-based chemotherapy as first-line therapy for metastatic triple-negative breast cancer: a meta-analysis of randomized controlled trials |
publisher |
SAGE Publishing |
series |
Technology in Cancer Research & Treatment |
issn |
1533-0338 |
publishDate |
2021-05-01 |
description |
Background: Triple-negative breast cancer constitutes approximately 12%-17% of all breast cancer cases, and >33% of patients develop distant metastases. Systemic cytotoxic chemotherapy is the primary treatment for patients with metastatic triple-negative breast cancer; however, the role of first-line platinum-based chemotherapy in these patients remains controversial. This meta-analysis evaluated the efficacy and safety of platinum-based first-line chemotherapy for patients with metastatic triple-negative breast cancer. Methods: We systematically searched the PubMed, Embase, Cochrane, and Clinical Trials registry databases up to June 1, 2020 to identify randomized controlled trials that investigated platinum-based vs. first-line platinum-free chemotherapy in patients with metastatic triple-negative breast cancer. We used fixed and random effects models to calculate pooled hazard ratios and odds ratios with 95% confidence intervals for progression-free and overall survival, objective response rates, and grade 3 and 4 adverse events. Results: Four randomized controlled trials ( N = 590 patients) were included. Platinum-based chemotherapy significantly increased the objective response rates from 43.1% to 62.7% (odds ratio 2.34, 95% confidence interval 1.66-3.28, P < 0.001). Three randomized controlled trials ( N = 414 patients) reported survival outcomes. Patients administered platinum-based regimens showed significantly longer progression-free survival (hazard ratio 0.55, 95% confidence interval 0.37-0.82, P = 0.004) and a nonsignificant trend toward improved overall survival (hazard ratio 0.76, 95% confidence interval 0.57-1.00, P = 0.05). Only 2 studies reported the rates of grade 3 and 4 adverse events; grade 3-4 thrombocytopenia was more commonly associated with platinum-based chemotherapy (odds ratio 7.54, 95% confidence interval 1.37-41.60, P = 0.02) and grade 3-4 fatigue with platinum-free chemotherapy (odds ratio 0.23, 95% confidence interval 0.08-0.68, P = 0.008). Conclusions: First-line platinum-based chemotherapy was associated with significantly increased objective response rates, longer progression-free survival, and a nonsignificant trend toward improved overall survival in patients with metastatic triple-negative breast cancer at the high risk of grade 3-4 thrombocytopenia. |
url |
https://doi.org/10.1177/15330338211016369 |
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