Meta-analysis Of The Efficacy And Safety Of Platinum In Neoadjuvant Chemotherapy For Triple-negative Breast Cancer

Objective:To evaluate the efficacy and safety of platinum in neoadjuvant chemotherapy for triple-negative breast cancer.Methods: A systematic search of Pubmed、Embase、Web of science、CBM、vip、cnki、Wanfang proceedings up to December 2019 was carried out to identify randomized controlled trials(RCTs)investigating platinum-based versus platinum-free neoadjuvant chemotherapy in TNBC patients.and the 5.3 software provided by the Cochrane collaboration was used for meta-analysis.Results: Twelve RCTs(N =2167)were included.Overall,pCR for platinum-based neoadjuvant chemotherapy was significantly increased(OR=2.11,95%CI:1.75-2.54,P<0.00001).Four RCTs investigated the addition of platinum agents to the standard neoadjuvant chemotherapy regimen of weekly paclitaxel(with or without carboplatin)followed by anthracycline plus cyclophosphamide(OR=2.60,95%CI:1.64-4.13,P<0.0001).The RCTs reported survival outcomes: no significant difference in EFS(HR=0.72,95%CI:0.49-1.06,P=0.10)、and OS(HR=0.86,95%CI:0.46-1.63,P=0.65).The clinical safety analysis results showed that statistically significant differences of neutropenia(OR=2.79,95%CI:1.42–5.47,P=0.003),anemia(OR=9.54,95%CI : 2.24–40.61,P=0.002),thrombocytopenia(OR=9.32,95%CI : 3.61–24.03,P <0.00001),nausea/vomiting(OR=1.59,95%CI:1.05–2.43,P=0.03),but there was no significant difference in the incidence of infection and fatigue.Conclusion:In TNBC patients,platinum-based neoadjuvant chemotherapy is associated with significantly increased pCR rates at the cost of worse hematological toxicities.