A Cochrane review [Abstract] 1 included 24 trials involving a total of 4 418 women. Triple-negative breast cancer (TNBC) is characterised by a lack of expression of oestrogen and progesterone receptors and human epidermal receptor 2 (HER2) and is assosiated with a shorter survival and higher likelihood of recurrence. In metatastatic TNBC platinum-containg regimens increased overall and progression-free survival compared with no platinum-containing regimens. In women with no TNBC, there was no response: the hazard ratio (HR) for overall survival was 1.01 (95% CI 0.92-1.12) and time to progression (overall HR 0.92; 95% CI 0.84-1.01). Adverse effects like leukopenia, hair loss, nausea and vomiting and anaemia were statistically significantly more common with platinum-containing regimens.
Another Cochrane review [Abstract] 3 included 13 trials involving a total of 1 349 women. In metatastatic triple-negative breast cancer platinum-containg regimens increased overall and progression-free survival compared with no platinum-containing regimens (table T1).
Outcome | Hazard ratio (95% CI) | Risk with control - non-platinum chemotherapy | Risk with intervention - Platinum chemotherapy (95% CI) | No of participants (studies) Quality of evidence |
---|---|---|---|---|
Overall survival: 1-year risk of death | HR 0.85 (0.73 to 1.00) | 510 per 1000 | 455 per 1000 (406 to 510) | 958 (6) Moderate |
Overall survival: 2-year risk of death | 711 per 1000 | 652 per 1000 (596 to 711) | ||
Progression -free survival: 1-year risk of death | HR 0.77 (0.68 to 0.88) | 936 per 1000 | 880 per 1000 (846 to 911) | 1077 (8) Very low |
Progression -free survival: 2-year risk of death | 970 per 1000 | 933 per 1000 (908 to 954) | ||
Objective tumour response rate | RR 1.40(1.22 to 1.59) | 368 per 1000 | 515 per 1000 (449 to 585) | 1205 (10) Low |
Another Cochrane review [Abstract] 2 included 20 trials. In early triple-negative breast cancer platinum-containg regimens (in neoadjuvant or adjuvant therapy) increased overall and progression-free survival compared with no platinum-containing regimens (table T2).
Outcome | Hazard ratio (95% CI) | Risk with control - non-platinum chemotherapy | Risk with intervention - Platinum chemotherapy (95% CI) | No of participants (studies) Quality of evidence |
---|---|---|---|---|
Neoadjuvant therapy | ||||
Disease free survival at 5 years (risk of recurrence) follow-up range 3 to 7.9 years | HR 0.63(0.53 to 0.75) | 301 per 1000 | 202 per 1000(173 to 235) | 1966(8) High |
Overall survival at 5 years;follow-up range 1.7 to 7.9 years | HR 0.69(0.55 to 0.86) | 190 per 1000 | 135 per 1000(110 to 166) | 1973(8) High |
Adjuvant therapy | ||||
Disease free survival at 5 years;follow-up range 4.3 to 8 years | HR 0.69(0.54 to 0.88) | 169 per 1000 | 120 per 1000(95 to 150) | 1256(4) High |
Overall survival at 5 years;follow-up range 4.3 to 8 years | HR 0.70(0.50 to 0.96) | 81 per 1000 | 57 per 1000(41 to 78) | 1256(4) High |
Primary/Secondary Keywords