| Background and Purpose:Platinum-based drugs such as cisplatin and carboplatin is a tumor cell DNA cross-linking agents,which coupled with DNA after entering the cell.It can lead to tumor cell DNA double-strand breaks,playing a role in killing cancer cells.This role is more effective in triple negative breast cancer.In order to clarify the role of platinum drugs in metastatic triple-negative breast cancer(TNBC).we process a systematic review and meta-analysis based on the studies that the platinum-based drugs treatment in metastatic triple negative breast cancer and all the studies are published on Pub Med, EMBASE, the Web of Science, SCOPUS, and the Cochrane Central Register of Controlled Trials.method:We searched databases such as pubmed, EMBASE, the Web of Science,SCOPUS and the Cochrane Central Register of Controlled Trials.We collected the randomized controlled study included platinum-based drug treatment and non-platinum-based drug treatment in metastatic TNBC.We also collected the clinical study of platinum drugs for patients with metastatic TNBC and non-TNBC of metastatic.We completed quality assessment in accordance with guidelines issued by Meta-Analysis of Observational Studies in Epidemiology group,using software Renew Manager 5.3 to process a meta-analysis.result:For metastatic TNBC,platinum-based drugs treatment and non-platinum-based drug treatment were compared.Seven randomized controlled study and 703 patients with metastatic TNBC were included.The meta-analysis shows:In metastatic triple-negative breast cancer(TNBC),Platinum-based chemotherapy compared tonon-platinum-based chemotherapy increased Objective response rate in patients significantly.(ORR)(RR = 1.87, 95 % CI 1.39–1.57;P<0.0001);When comparing The PFS of 6 month,12 month and 18 month,we find the platinum drugs group was significantly higher than non-platinum group( 6 month PFS RR=1.29 95% CI:1.10–1.51,P=0.002;12 month PFS RR=2.03 95% CI: 1.38–3.00,P=0.0003;18month PFS RR=2.43 95% CI: 1.28–4.61,P<0.007).When we compared the III / IV grade hematologic toxicity and neurotoxicity of the two groups,there was no Significant difference.The incidence of gastrointestinal toxicity of platinum-based drugs treatment was higher than non-platinum-based drug treatment.The difference has statistical significance(RR=5.46 95% CI: 2.39–12.47,P<0.0001).When comparing OS of this two groups, there is no statistical significance.For Patinum-based drugs treatment of metastatic TNBC and metastatic non-triple negative breast cancer,four retrospective clinical controlled study and a total of 424 cases of patients were included.The OS of metastatic TNBC is significantly higher than metastatic non-triple negative breast cancer,when they were all platinum-based drugs treatment.(12 month OS RR=1.43 95% CI: 1.04–1.97,24 month OS RR=1.7695% CI: 1.08–2.87,P=0.02).When comparing OS of this two groups,there is no statistical significance.conclusion:For chemotherapy of metastatic TNBC,compared to the non-platinum-based therapy group,Platinum therapy group Significantly improved the prognosis of patients and improve OR.The Toxicity was in the range of tolerable.For Platinum-based chemotherapy,compared to metastatic non-triple negative breast cancer group,metastatic TNBC group Significantly improved OR of patients.However, no significant advantage in PFS. |
PDF Full Text Request